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Open Letter to Congressional Leadership Regarding H.R. 6

September 20, 2018

Senator Orrin Hatch
Chairman, Senate Finance Committee
United States Senate

Senator Ron Wyden
Ranking Member, Senate Finance Committee
United States Senate

The Honorable Kevin Brady
Chairman, Ways & Means Committee
United States House of Representatives

The Honorable Richard Neal
Ranking Member, Ways and Means Committee
United States House of Representatives

Chairmen Hatch and Brady and Ranking Members Wyden and Neal:

Advocates for Opioid Recovery is an organization promoting the evidence-based interventions that can have a dramatic impact on ending the opioid addiction and overdose crisis. The objective of Advocates for Opioid Recovery is to advance a science-based, evidence-based treatment system that can reduce death and suffering from opioid addiction and empower more Americans to become long-term opioid addiction survivors who are positively engaged in their families and communities.

We commend you for your leadership in working to address the greatest public health crisis of our generation. Both the House and Senate’s opioid packages incorporate many of AOR’s policy recommendations that support our goals of eliminating the bias against addiction, expanding treatment capacity, enforcing insurance parity laws, and expanding evidence-based treatment within the criminal justice system.

Although there is no single strategy to address the crisis, breaking down barriers to evidence-based treatment – including recovery medication and other supports – should be the highest priority to make long-term recovery a reality for those affected by opioid use disorder. However, we remain concerned that Medicare and some state Medicaid programs do not cover the most cost-effective, evidence-based treatment modality — opioid treatment programs (OTPs).

OTPs are highly-regulated, highly-effective, comprehensive treatment programs that provide medication-assisted treatment (MAT) – the combination of medication with behavioral therapy and support. MAT has been recognized as the gold standard of care for opioid use disorder by the NIH and other organizations for decades. Studies show that people who receive MAT are 75 percent less likely to have an addiction-related death than those who do not receive MAT.

Since Medicare does not cover addiction treatment at OTPs, America’s seniors and other Medicare beneficiaries are without access to the evidence-based standard of care. As you meet to rectify the difference between the two opioid measures, we urge you to adopt the House-passed language which provides permanent Medicare OTP coverage through bundled payments. We don’t need a demonstration program – we know what works.

There are several other evidence-based approaches in each of the passed bills that we encourage negotiators to incorporate into the final version:

  • Requiring state Medicaid programs to cover all forms of medication-assisted treatment, including methadone and counseling services, for opioid use disorders through 2025.
  • Providing an enhanced federal reimbursement for state Medicaid expenditures related to the expansion of substance-use treatment and recovery services.
  • Codifying rules enabling more DATA 2000 providers and allowing them to provide medication-assisted treatment to more patients.
  • Requiring the Drug Enforcement Administration (DEA) to issue final regulations for registering telemedicine providers to prescribe controlled substances within one year of enactment.
  • Allowing the Health and Human Services Department (HHS) to waive Medicare requirements for telehealth coverage when treating a substance use disorder.
  • Reporting on federal investigations of health plans that violate requirements to provide equal coverage of mental health and substance use disorders.
  • Directing the Labor Department to carry out a pilot program to address the economic and workforce effects of substance use disorders.
  • Prohibiting states from terminating Medicaid coverage for juveniles younger than 21 while in jail and require to states restore Medicaid coverage for eligible adults transitioning out of incarceration without requiring a new application.
  • Providing grants to nonprofit groups to provide technical assistance to drug courts.
  • Supporting recovery centers that provide the full continuum of evidence-based treatment services.

In supporting these provisions and others, we call on committee leadership to remain focused on the expansion and implementation of evidence-based treatments.

Sincerely,

Anne Woodbury
Executive Director
Advocates for Opioid Recovery

Download the PDF version of the letter.

2018-10-11T17:49:39+00:00