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Michael Petruzzelli

, National Council for Behavioral Health

HHS Announces Latest Actions to Address Opioid Abuse

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The Department of Health and Human Services (HHS) this week announced several new initiatives to combat the nation’s opioid epidemic.  These include: raising the medication-assisted treatment (MAT) prescriber cap to 275 patients per practitioner, delaying proposed reporting requirements for providers, and announcing more than a dozen new scientific studies on opioid use and abuse. HHS is also seeking feedback on how to improve and expand government prescriber education and training programs to prevent opioid misuse and overdoses.

Key provisions of the final rule include:

  • Buprenorphine Cap: HHS will expand access to medication-assisted treatment and raise the patient limit beyond 200, as originally proposed, to 275. Under the rule, practitioners who have had a waiver to treat 100 patients for at least one year could obtain approval to treat up to 275 patients if they submit a Request for Patient Limit Increase form to the Substance Abuse and Mental Health Services Administration (SAMHSA) and meet certain other requirements.
  • Qualified Practice Setting: Such a setting must meet the following criteria: provides professional coverage for patient medical emergencies during hours when the practitioner’s practice is closed; provides access to case-management services for patients; uses health information technology (HIT) systems such as electronic health records; is registered for their State prescription drug monitoring program (PDMP) where operational and in accordance with federal and State law; and accepts third-party payment.
  • Additional Practitioner Responsibility under the New Limit: Under the new limit, prescribers will be required to accept greater responsibility for providing behavioral health services and care coordination. Additionally, providers will be subject to requirements for quality assurance and improvement practices, diversion control, and continuity of care in emergencies. Note: These additional requirements will not apply to providers who do not apply for the higher limit.
  • Emergency Situations: Physicians may request approval to treat up to 200 patients in specific emergency situations for a limited time period. The rule – to be used sparingly – will allow a “covering practitioner” to prescribe medication to a different physician’s patient without going over his or her own limit.
PROVIDE ADDITIONAL FEEDBACK

Under the proposed rule, prescribers under the higher limit must participate in data reporting and monitoring, including monthly caseload of MAT patients, the percentage of patients receiving mental health services, and the amount of patients who received a prescription drug monitoring program query. HHS has decided to delay these reporting requirements, and instead will solicit additional comments on the proposed reporting requirements. Comments are due within 30 days of official publication – on or around Aug. 7, 2016.