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Stephanie Pellitt

, National Council for Behavioral Health

House Committee Sends Opioid Package to House Floor

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On Thursday, the House Energy and Commerce Committee reviewed remaining opioid legislation to be included in a large package aimed at addressing the opioid crisis, an effort which began last week in the full Committee. The Committee approved 32 bills, a week after approving another 25 opioid measures, bringing the total up to 57. Bills that advanced this week include provisions to loosen both the Institution for Mental Disease (IMD) rule on residential substance use disorder (SUD) treatment and privacy rules governing SUD treatment records, promote best practices for recovery housing and to ensure mental health and SUD parity in the Children’s Health Insurance Program (CHIP).

Among the bills approved during Thursday’s hearing:

  • Residential SUD Treatment: The IMD CARE Act (H.R. 5797), would amend the Institutes of Mental Disease (IMD) rule to allow Medicaid to pay for patient stays of up to 30 days in an IMD for residential addiction treatment. Coverage would be limited to patients with opioid use disorders and the change would effective from FY 2019 through 2023. Earlier versions of the bill were more similar to Senate’s Medicaid CARE Act (S. 1169), which would allow for patient stays of up to 90 days in an IMD for any substance use disorder. The National Council has long supported and advocated for a change to the IMD restrictions on residential addiction treatment.
  • 42 CFR Part 2: The Overdose Prevention and Patient Safety Act (H.R. 3545) would amend federal regulation (known as 42 CFR Part 2), aligning it with the Health Information Portability and Accountability Act or HIPAA, the law that governs privacy standards for other health care records. The sharing of substance use treatment records typically requires signed patient consent; however, H.R. 3545 would allow for the sharing of patient information without such authorization for the purposes of treatment, payment or other health care operations like case management and care coordination.
  • Recovery Housing: The Ensuring Access to Quality Sober Living Act (H.R.4684) would have the Substance Abuse and Mental Health Services Administration (SAMHSA) disseminate recovery housing best practices, based on the National Alliance for Recovery Residence’s quality standards, to the states and provide them with technical assistance to implement the standards. The bill aligns closely with the recommendations of the National Council’s State Policy Guide for Supporting Recovery Housing.
  • CHIP Mental Health/SUD Parity: The CHIP Mental Health Parity Act (H.R. 3192) would ensure children on CHIP could access mental health and substance use services at parity with other health care services. This bill is supported is supported by the National Council.

A full list of the bills passed by the Committee can be found here.

DEBATE

While the proceedings were mostly bipartisan, there was notable contention over the IMD and 42 CFR Part 2 measures. The debate largely fell along party lines with Democrats raising concerns that the IMD measure could lessen access to non-residential types of SUD treatment and that loosening 42 CFR Part 2 could deter people from seeking SUD treatment at the risk of their information being exposed and facing discrimination. The partisan debate also halted the passage of the Addiction Treatment Access Improvement Act, a National Council-supported bill that seeks to expand access to MAT by allowing new provider types to prescribe buprenorphine, a medication utilized in MAT.

WHAT’S NEXT?

The 32 measures now head to the House floor alongside 25 bills passed by House Energy and Commerce Committee last week and opioid-related measures from other House committees. The flurry of activity this week keeps the House on track to hold a full chamber vote on an opioid-package by the end of June.