SUPPORT for Patients and Communities Act of 2018 - H.R.6

Congress passed H.R.6, which  is a 660-page bipartisan bill that attempts to address nearly every aspect of the public health epidemic, from expanding access to addiction treatment and prevention programs to beefing up law enforcement efforts to curtail the trafficking of illegal drugs.

Summary

This bill makes several changes to state Medicaid programs to address opioid and substance use disorders. Specifically, the bill:

• modifies provisions related to coverage for juvenile inmates and former foster care youth,
• establishes a demonstration project to increase provider treatment capacity for substance use disorders,
• requires the establishment of drug management programs for at-risk beneficiaries,
• establishes drug review and utilization requirements,
• extends the enhanced federal matching rate for expenditures regarding substance use disorder health home services, and
• temporarily requires coverage of medication-assisted treatment.

The bill also alters Medicare requirements to address opioid use. Specifically, the bill:

• exempts substance use disorder telehealth services from specified requirements,
• requires the initial examination for new enrollees to include an opioid use disorder screening,
• modifies provisions regarding electronic prescriptions and post-surgical pain management,
• requires prescription drug plan sponsors to establish drug management programs for at-risk beneficiaries, and
• requires coverage for services provided by certified opioid treatment programs.

The bill also addresses other opioid-related issues. Specifically, the bill:

• establishes and expands programs to support increased detection and monitoring of fentanyl and other synthetic opioids, and
• increases the maximum number of patients that health care practitioners may initially treat with medication-assisted treatment (i.e., under a buprenorphine waiver).

Additionally, the bill temporarily eliminates the enhanced federal matching rate for Medicaid expenditures regarding specified medical services provided by certain managed care organizations.

Background

In 2016, more than 63,600 people died from an overdose in the United States -- and 42,249 of those deaths involved an opioid, according to the Centers for Disease Control and Prevention.

Cost

Click here for a cost analysis from the Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT).