AOR Policy Recommendations

Expand Evidence-based Treatment Capacity

  • Broaden the pool of providers eligible to be reimbursed under physical and behavioral health plans for providing medication assisted treatment to include all providers (e.g., physicians, nurse practitioners, physician assistants) regardless of primary specialty, and recruit new providers
  • Remove barriers to telemedicine, especially in rural and underserved areas (which also tend to have higher incidence of opioid use disorder)
  • Remove the cap on the number of patients providers with specialty training can treat with buprenorphine.
  • Develop innovative payment models that facilitate contracting relationships for opioid addiction treatment, like bundled rates, direct payments for care coordination and case management services, and rational approaches to coverage of appropriate drug testing
  • Remove the Medicaid Institutions for Mental Disease (IMD) exclusions, which prevents many facilities from receiving Medicaid reimbursements and reduces their capacity to treat the most vulnerable in our society
  • Clarify and enforce recovery medication prescribing practices that adhere to federal and industry practice guidelines, to avoid poor quality practices that lead to diversion

Enforce Parity and Break Down Barriers to Insurance Coverage

  • Fully enforce mental health and addiction parity across all healthcare coverage
  • Enforce the requirement of adequate provider networks and treatment coverage for all plans purchased by the federal government
  • Reward plans that comply with parity laws and those with improved treatment outcomes
  • Provide seed funding for development of accreditation or certification programs that distinguish high quality treatment programs adhering to evidence-based practices

Decriminalize Addiction: More Patients, Less Prisoners

  • As much as possible, divert individuals struggling with addiction into evidence based community-based treatment and support services, not jail or prison
  • Increase federal funding for drug court programs that encourage medication assisted treatment
  • Expand access to treatment options for incarcerated individuals
  • Support a “re-entry” program for people living with addiction after incarceration

Educate Public and Medical Professionals

  • Require that federally-supported medical, nursing and other clinician training programs incorporate curriculum on the diagnosis and treatment of addiction
  • Invest resources in scaling evidence-based prevention programs and customizing for specific priority audiences such as youth, veterans, pain patients, etc.
  • Develop targeted campaigns (e.g. public, medical professionals) to fight the bias against people with addiction and inform of effective treatment options

Accelerate Innovation through FDA Reform

  • Accelerate treatments for opioid use disorder that are nearly diversion-proof such as long-action injectables and implantables
  • Fast-track non-addictive pain medication development through the National Institutes of Health (NIH)

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