President Trump has just signed into law HR 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.  The bipartisan legislation includes almost 200 provisions intended to strengthen opioid prevention and treatment efforts and bolster law enforcement tools.

Among many other things, the new law: 

  • Seeks to encourage non-opioid treatment options and the development of non-addictive pain products to treat and manage pain through a variety of Medicare and Medicaid reforms and through an examination of related Food and Drug Administration (FDA) policies.
  • Modifies Medicare Part D drug policies with regard to e-prescribing for controlled substances and drug management programs for at-risk beneficiaries.
  • Provides Medicare coverage of opioid use disorder treatment services furnished by an opioid treatment program.
  • Requires the Centers for Medicare & Medicaid Services (CMS) to develop guidance for hospitals on pain management and opioid use disorder prevention and to review Medicare quality measures related to opioids and opioid use disorders.
  • Establishes a demonstration program to test pain management protocols to limit the use of opioids in hospital emergency departments.
  • Expands Medicaid drug review and utilization requirements to address opioid safety.
  • Directs CMS to issue guidance to states on options for providing Medicaid substance use disorder services via telehealth; such services could include assessment, medication-assisted treatment, counseling, medication management, and medication adherence with prescribed medication regimes.
  • Directs the Secretary of Health and Human Services to report on innovative state initiatives for providing housing-related services to support Medicaid enrollees experiencing or at risk of homelessness.
  • Provides $10 million annually in FYs 2019-2023 for grants to establish Comprehensive Opioid Recovery Centers.
  • Establishes mechanisms and promotes the use and development of technology to detect the entry of narcotics into the US through postal shipments.

In addition, HR 6 makes it illegal to knowingly and willfully pay or receive remuneration in return for referring an individual to a recovery home, clinical treatment facility, or laboratory, with respect to services covered by a health care benefit program in or affecting interstate or foreign commerce.  The provision includes certain exceptions intended to protect “legitimate referrals,” and it does not apply to conduct that is prohibited under 42 U.S.C. 1320a–7b (the Federal Anti-Kickback Statute).  Penalties for violations include fines of up to $200,000 and/or 10 years in prison for each occurrence.

Also notably, HR 6 expands the Open Payments program to require manufacturers to report certain payments or transfers of value to the following additional types of practitioners:  physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives. This provision applies to reports submitted beginning January 1, 2022.