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On the Hill: House Passes ALTO Bill, Opioid Debate Continues

Congress continues to work on passing bipartisan opioid legislation before the July Fourth recess next week.

The House last week passed 25 opioid-related bills, including one modeled on a program developed at essential hospital St. Joseph’s Regional Medical Center, in Paterson, N.J.

This bill, H.R. 5197, the Alternatives to Opioids (ALTO) in the Emergency Department Act, would require the Department of Health and Human Services to carry out a three-year demonstration program that awards grants to hospitals and emergency departments to develop, implement, enhance, or study alternative pain management protocols and treatments that promote limited use of opioids. It is expected a larger legislative package will include the ALTO bill.

Also, leadership from both the House Committee on Energy and Commerce and the House Committee on Ways and Means introduced H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. This bill includes several Medicaid, Medicare, and public health reforms to combat the opioid crisis and will serve as the vehicle for the majority of the recently passed House bills. H.R. 6:

  • requires the Centers for Medicare & Medicaid Services (CMS) to carry out a demonstration project that provides an enhanced federal matching rate for state Medicaid expenditures related to the expansion of substance use treatment and recovery services targeting providers;
  • provides access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to opioid treatment programs for holistic service; and
  • instructs CMS to evaluate telehealth services to treat substance use disorder.

The House is expected to vote on additional opioid bills this week and to combine all approved measures into one package for Senate consideration later this month.

In the Senate, the Senate Committee on Finance unanimously approved S.2680, the Helping To End Addiction And Lessen (HEAL) Substance Use Disorders Act Of 2018 last week. This bill would:

  • expand telehealth services;
  • allow states to receive federal Medicaid payments for expenditures included in the development of managed care capitulation rates for treatment;
  • ensure that Medicare and Medicaid improve education, prevention, and management and treatment options for pain and addiction;
  • expand options for treating beneficiaries suffering from addiction and improve data used to evaluate approaches that address opioid use; and
  • increase Medicare beneficiary awareness of non-opioid alternative treatments, increase treatment for substance use disorder, and improve tracking of opioid prescriptions under Medicare Part D.

Other Committee Activity

The Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold a June 19 hearing on the effective administration of the 340B Drug Pricing Program. Capt. Krista Pedley, PharmD, MS, director of the Health Resources and Services Administration’s Office of Pharmacy Affairs, will testify.

The Senate HELP Committee will hold a hearing June 27 on reducing health care costs.



About the Author

Erin Delaney is a former legislative affairs associate at America's Essential Hospitals.

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