At-Risk Youth Medicaid Protection Act of 2018

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5685) to amend title XVIII of the Social Security Act to provide educational resources regarding opioid use and pain management as part of the Medicare & You handbook.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks and insert extraneous materials in the Record on the bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I commend Representatives Faso, Welch, and Renacci. They all worked hard to develop this bipartisan bill, and I thank them for their work.

The Medicare Opioid Safety Education Act directs the Centers for Medicare and Medicaid Services to include information about the risk of opioid use, potential nonopioid pain management treatments, and other relevant information in the Medicare & You handbook that is published annually.

The Medicare programs provide healthcare coverage to over 58 million users. We want to empower every person on Medicare to be able to have a thoughtful conversation with his or her provider about their prescriptions and the possible alternatives. Education is a big part of what we are doing here.

The Medicare & You handbook is provided to every beneficiary and represents an education point for those on opioids and those who may, in the future, need to have a discussion about pain treatment options with their physician.

We are rightfully seizing upon this opportunity to inform as many people as possible and educate them about the long-term opioid use and misuse. It is always a good thing to do. It is another tool in the toolbox when it comes to beneficiary outreach and education.

Mr. Speaker, I urge my colleagues to vote ``yes'' on H.R. 5685.

House of Representatives,

Committee on Energy and Commerce,

Washington, DC, June 7, 2018.

Hon. Kevin Brady,

Chairman, Committee on Ways and Means,

Washington, DC.

Dear Chairman Brady: On May 9 and 17, 2018, the Committee

on Energy and Commerce ordered favorably reported over 50

bills to address the opioid epidemic facing communities

across our nation. Several of the bills were also referred to

the Committee on Ways and Means.

I ask that the Committee on Ways and Means not insist on

its referral of the following bills so that they may be

scheduled for consideration by the Majority Leader:

H.R. 1925, At-Risk Youth Medicaid Protection Act of 2017;

H.R. 3331, To amend title XI of the Social Security Act to

promote testing of incentive payments for behavioral health

providers for adoption and use of certified electronic health

record technology;

H.R. 3528, Every Prescription Conveyed Securely Act;

H.R. 4841, Standardizing Electronic Prior Authorization for

Safe Prescribing Act of 2018;

H.R. 5582, Abuse Deterrent Access Act of 2018;

H.R. 5590, Opioid Addiction Action Plan Act;

H.R. 5603, Access to Telehealth Services for Opioid Use

Disorder;

H.R. 5605, Advancing High Quality Treatment for Opioid Use

Disorders in Medicare Act;

H.R. 5675, To amend title XVIII of the Social Security Act

to require prescription drug plan sponsors under the Medicare

program to establish drug management programs for at-risk

beneficiaries;

H.R. 5684, Protecting Seniors from Opioid Abuse Act;

H.R. 5685, Medicare Opioid Safety Education Act;

H.R. 5686, Medicare Clear Health Options in Care for

Enrollees (CHOICE) Act;

H.R. 5715, Strengthening Partnerships to Prevent Opioid

Abuse Act;

H.R. 5716, Commit to Opioid Medical Prescriber

Accountability and Safety for Seniors (COMPASS) Act;

H.R. 5796, Responsible Education Achieves Care and Healthy

Outcomes for Users' Treatment (REACH OUT) Act of 2018;

H.R. 5798, Opioid Screening and Chronic Pain Management

Alternatives for Seniors Act;

H.R. 5804, Post-Surgical Injections as an Opioid

Alternative Act; and

H.R. 5809, Postoperative Opioid Prevention Act of 2018.

This concession in no way affects your jurisdiction over

the subject matter of these bills, and it will not serve as

precedent for future referrals. In addition, should a

conference on the bills be necessary, I would support your

request to have the Committee on Ways and Means on the

conference committee. Finally, I would be pleased to include

this letter and your response in the bill reports and the

Congressional Record.

Thank you for your consideration of my request and for the

extraordinary cooperation shown by you and your staff over

matters of shared jurisdiction. I look forward to further

opportunities to work with you this Congress.

Sincerely,

Greg Walden,

Chairman.

Mr. Speaker, I yield as much time as he may consume to the gentleman from New York (Mr. Faso), a very capable and able legislator. This is his legislation, in part, and he has been a real leader in this overall effort, and certainly on this piece of legislation.

Mr. Speaker, I urge my colleagues to support this very important and bipartisan legislation, and I yield back the balance of my time.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 3331) to amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous materials in the Record.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I want to commend Representative Jenkins, who is here and going to speak in a moment; Representative Matsui, who is also here and going to speak in a moment; Representative Mullin; and others who are working together on this bill.

H.R. 3331 will open an opportunity to accelerate the use of electronic health records for behavioral health providers. Behavioral health providers were left out of the HITECH incentives, leading to a lower rate of adoption and creating a gap in continuity of care at a point when it is most needed.

If there is one place you don't want a data-drop in care provided it is with those who have sought care, but their doctors don't know about it because they don't have the technology they need. No patient should face the risks of being rerouted to opioids because their provider did not have the full picture of a patient's history.

During the thorough legislative process the Energy and Commerce Committee has engaged in to get here today, we have heard from several witnesses and stakeholders on the importance of better utilizing technology. So it is a natural step to let CMMI test the impact of connecting behavioral health providers with the rest of the healthcare community.

Mr. Speaker, I urge my colleagues to support the passage of H.R. 3331.

House of Representatives,

Committee on Energy and Commerce,

Washington, DC, June 7, 2018.

Hon. Kevin Brady,

Chairman, Committee on Ways and Means,

Washington, DC.

Dear Chairman Brady: On May 9 and 17, 2018, the Committee

on Energy and Commerce ordered favorably reported over 50

bills to address the opioid epidemic facing communities

across our nation. Several of the bills were also referred to

the Committee on Ways and Means.

I ask that the Committee on Ways and Means not insist on

its referral of the following bills so that they may be

scheduled for consideration by the Majority Leader:

H.R. 1925, At-Risk Youth Medicaid Protection Act of 2017;

H.R. 3331, To amend title XI of the Social Security Act to

promote testing of incentive payments for behavioral health

providers for adoption and use of certified electronic health

record technology;

H.R. 3528, Every Prescription Conveyed Securely Act;

H.R. 4841, Standardizing Electronic Prior Authorization for

Safe Prescribing Act of 2018;

H.R. 5582, Abuse Deterrent Access Act of 2018;

H.R. 5590, Opioid Addiction Action Plan Act;

H.R. 5603, Access to Telehealth Services for Opioid Use

Disorder;

H.R. 5605, Advancing High Quality Treatment for Opioid Use

Disorders in Medicare Act;

H.R. 5675, To amend title XVIII of the Social Security Act

to require prescription drug plan sponsors under the Medicare

program to establish drug management programs for at-risk

beneficiaries;

H.R. 5684, Protecting Seniors from Opioid Abuse Act;

H.R. 5685, Medicare Opioid Safety Education Act;

H.R. 5686, Medicare Clear Health Options in Care for

Enrollees (CHOICE) Act;

H.R. 5715, Strengthening Partnerships to Prevent Opioid

Abuse Act;

H.R. 5716, Commit to Opioid Medical Prescriber

Accountability and Safety for Seniors (COMPASS) Act;

H.R. 5796, Responsible Education Achieves Care and Healthy

Outcomes for Users' Treatment (REACH OUT) Act of 2018;

H.R. 5798, Opioid Screening and Chronic Pain Management

Alternatives for Seniors Act;

H.R. 5804, Post-Surgical Injections as an Opioid

Alternative Act; and

H.R. 5809, Postoperative Opioid Prevention Act of 2018.

This concession in no way affects your jurisdiction over

the subject matter of these bills, and it will not serve as

precedent for future referrals. In addition, should a

conference on the bills be necessary, I would support your

request to have the Committee on Ways and Means on the

conference committee. Finally, I would be pleased to include

this letter and your response in the bill reports and the

Congressional Record.

Thank you for your consideration of my request and for the

extraordinary cooperation shown by you and your staff over

matters of shared jurisdiction. I look forward to further

opportunities to work with you this Congress.

Sincerely,

Greg Walden,

Chairman.

Mr. Speaker, I yield 3 minutes to the gentlewoman from Kansas (Ms. Jenkins), who has been a real leader on this legislation.

Mr. Speaker, I have no other speakers, so I reserve the balance of my time.

Mr. Speaker, I thank Members on both sides for their good work on this legislation. I urge passage, and I yield back the balance of my time.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5796) to require the Secretary of Health and Human Services to provide grants for eligible entities to provide technical assistance to outlier prescribers of opioids, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous materials on the bill under consideration.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I want to commend my colleague Representative Fitzpatrick, who is here on the floor with us today, as well as Representative Curbelo and Representative Thompson. They all worked very hard to make this bipartisan legislation a success.

H.R. 5796 would establish technical assistance grants to make best practices available to those providers who are identified as opioid- prescribing outliers. This bill would establish a means of identifying statistical outliers and then notifying providers if they are an outlier.

In addition, the bill authorizes quality improvement organizations and other grant recipients to review prescribing patterns and to share educational materials and best practices. This legislation will ensure that best prescribing practices are clinically appropriate for patients and are implemented throughout the Medicare program.

House of Representatives,

Committee on Energy and Commerce,

Washington, DC, June 7, 2018.

Hon. Kevin Brady,

Chairman, Committee on Ways and Means,

Washington, DC.

Dear Chairman Brady: On May 9 and 17, 2018, the Committee

on Energy and Commerce ordered favorably reported over 50

bills to address the opioid epidemic facing communities

across our nation. Several of the bills were also referred to

the Committee on Ways and Means.

I ask that the Committee on Ways and Means not insist on

its referral of the following bills so that they may be

scheduled for consideration by the Majority Leader:

H.R. 1925, At-Risk Youth Medicaid Protection Act of 2017;

H.R. 3331, To amend title XI of the Social Security Act to

promote testing of incentive payments for behavioral health

providers for adoption and use of certified electronic health

record technology;

H.R. 3528, Every Prescription Conveyed Securely Act;

H.R. 4841, Standardizing Electronic Prior Authorization for

Safe Prescribing Act of 2018;

H.R. 5582, Abuse Deterrent Access Act of 2018;

H.R. 5590, Opioid Addiction Action Plan Act;

H.R. 5603, Access to Telehealth Services for Opioid Use

Disorder;

H.R. 5605, Advancing High Quality Treatment for Opioid Use

Disorders in Medicare Act;

H.R. 5675, To amend title XVIII of the Social Security Act

to require prescription drug plan sponsors under the Medicare

program to establish drug management programs for at-risk

beneficiaries;

H.R. 5684, Protecting Seniors from Opioid Abuse Act;

H.R. 5685, Medicare Opioid Safety Education Act;

H.R. 5686, Medicare Clear Health Options in Care for

Enrollees (CHOICE) Act;

H.R. 5715, Strengthening Partnerships to Prevent Opioid

Abuse Act;

H.R. 5716, Commit to Opioid Medical Prescriber

Accountability and Safety for Seniors (COMPASS) Act;

H.R. 5796, Responsible Education Achieves Care and Healthy

Outcomes for Users' Treatment (REACH OUT) Act of 2018;

H.R. 5798, Opioid Screening and Chronic Pain Management

Alternatives for Seniors Act;

H.R. 5804, Post-Surgical Injections as an Opioid

Alternative Act; and

H.R. 5809, Postoperative Opioid Prevention Act of 2018.

This concession in no way affects your jurisdiction over

the subject matter of these bills, and it will not serve as

precedent for future referrals. In addition, should a

conference on the bills be necessary, I would support your

request to have the Committee on Ways and Means on the

conference committee. Finally, I would be pleased to include

this letter and your response in the bill reports and the

Congressional Record.

Thank you for your consideration of my request and for the

extraordinary cooperation shown by you and your staff over

matters of shared jurisdiction. I look forward to further

opportunities to work with you this Congress.

Sincerely,

Greg Walden,

Chairman.

Mr. Speaker, I yield such time as he may consume to the gentleman from Pennsylvania (Mr. Fitzpatrick), one of the authors of this important legislation.

Mr. Speaker, I thank my colleagues for their bipartisan support of this legislation.

We also were just notified not long ago about the appropriations flag, and we are working out those matters at a higher pay level. So, we appreciate and understand.

Mr. Speaker, I urge passage of this legislation, and I yield back the balance of my time.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5590) to require the Secretary of Health and Human Services to provide for an action plan on recommendations for changes under Medicare and Medicaid to prevent opioids addictions and enhance access to medication-assisted treatment, and for other purposes, as amended.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and insert extraneous materials in the Record on the bill.

Mr. Speaker, I yield myself as much time as I may consume.

Mr. Speaker, I want to commend Representative Kinzinger, Representative Clarke, Representative LaHood, and Representative Davis for their work on this important bipartisan bill.

H.R. 5590 requires the Department of Health and Human Services to develop an opioid addiction plan to evaluate what HHS is doing across the department to address the opioid crisis and how it can be improved. This action plan will include an evaluation of coverage and reimbursement rates for nonopioid pain treatments, the potential role of medical devices in addressing this crisis, and the availability of treatment for rural and medically underserved communities, among other components.

In addition, Medicare and Medicaid are on the front lines of this epidemic, and we need to be sure that they are not creating adverse incentives that can harm beneficiaries with coverage and reimbursement decisions.

The issues addressed in this bill will also provide an informative review of how CMS can continue to fight this national crisis.

Mr. Speaker, I urge my colleagues to support and pass this bipartisan bill, and I reserve the balance of my time.

House of Representatives,

Committee on Energy and Commerce,

Washington, DC, June 7, 2018.

Hon. Kevin Brady,

Chairman, Committee on Ways and Means,

Washington, DC.

Dear Chairman Brady: On May 9 and 17, 2018, the Committee

on Energy and Commerce ordered favorably reported over 50

bills to address the opioid epidemic facing communities

across our nation. Several of the bills were also referred to

the Committee on Ways and Means.

I ask that the Committee on Ways and Means not insist on

its referral of the following bills so that they may be

scheduled for consideration by the Majority Leader:

H.R. 1925, At-Risk Youth Medicaid Protection Act of 2017;

H.R. 3331, To amend title XI of the Social Security Act to

promote testing of incentive payments for behavioral health

providers for adoption and use of certified electronic health

record technology;

H.R. 3528, Every Prescription Conveyed Securely Act;

H.R. 4841, Standardizing Electronic Prior Authorization for

Safe Prescribing Act of 2018;

H.R. 5582, Abuse Deterrent Access Act of 2018;

H.R. 5590, Opioid Addiction Action Plan Act;

H.R. 5603, Access to Telehealth Services for Opioid Use

Disorder;

H.R. 5605, Advancing High Quality Treatment for Opioid Use

Disorders in Medicare Act;

H.R. 5675, To amend title XVIII of the Social Security Act

to require prescription drug plan sponsors under the Medicare

program to establish drug management programs for at-risk

beneficiaries;

H.R. 5684, Protecting Seniors from Opioid Abuse Act;

H.R. 5685, Medicare Opioid Safety Education Act;

H.R. 5686, Medicare Clear Health Options in Care for

Enrollees (CHOICE) Act;

H.R. 5715, Strengthening Partnerships to Prevent Opioid

Abuse Act;

H.R. 5716, Commit to Opioid Medical Prescriber

Accountability and Safety for Seniors (COMPASS) Act;

H.R. 5796, Responsible Education Achieves Care and Healthy

Outcomes for Users' Treatment (REACH OUT) Act of 2018;

H.R. 5798, Opioid Screening and Chronic Pain Management

Alternatives for Seniors Act;

H.R. 5804, Post-Surgical Injections as an Opioid

Alternative Act; and

H.R. 5809, Postoperative Opioid Prevention Act of 2018.

This concession in no way affects your jurisdiction over

the subject matter of these bills, and it will not serve as

precedent for future referrals. In addition, should a

conference on the bills be necessary, I would support your

request to have the Committee on Ways and Means on the

conference committee. Finally, I would be pleased to include

this letter and your response in the bill reports and the

Congressional Record.

Thank you for your consideration of my request and for the

extraordinary cooperation shown by you and your staff over

matters of shared jurisdiction. I look forward to further

opportunities to work with you this Congress.

Sincerely,

Greg Walden

Chairman.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I rise to support H.R. 5605, the Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act.

I introduced the bill to give older Americans across our Nation more access to comprehensive addiction treatment services through Medicare. Seniors are frequently prescribed opioids to treat chronic illnesses with constant, lasting pain issues, such as arthritis and other issues related to their musculoskeletal system.

The frequency and chronicity of this prescribing puts them at risk of developing a dependency, as seniors are more physiologically vulnerable to experiencing dependency and overdose effects. That is because as you get older your physiology changes, which makes seniors less able to deal with the side effects of opioids and more prone to respiratory depression, the leading cause of opioid-related death.

When you consider that roughly one-third of Medicare beneficiaries received an opioid prescription in 2016, with over half a million receiving a high dose, it makes sense that the hospitalization rate related to opioid misuse in patients over 65 has increased by 500 percent in the past two decades.

Despite these heightened risk factors, many seniors still do not have access to comprehensive, evidence-based treatment under traditional Medicare, and we cannot leave our seniors behind as we work to address this national crisis. Our seniors deserve access to the gold standard of care for treating opioid addiction. It is that simple.

My bill, H.R. 5605, the Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act, will open doors for older Americans to get that gold standard of care by strengthening Medicare for our seniors. My bill does this by creating an alternative payment model demonstration program through Medicare for comprehensive treatment and care programs for opioid misuse disorder and will establish quality measures that reward comprehensive treatment programs that actually produce the best patient outcomes.

It works by giving providers and institutions that choose to participate a case management payment, which they would use to provide wraparound services for Medicare beneficiaries. Teams with an addiction specialist would also receive a higher incentive. Seniors participating in this program will receive medication-assisted treatment alongside psychosocial support, such as psychotherapy, treatment planning, and appropriate social services.

This coordinated care approach is considered the gold standard of care, and if we want to successfully address this crisis, we need to ensure that individuals have access to treatments that will result in successful outcomes. I have seen firsthand the importance of this with my own patients in the emergency department. Getting medication- assisted treatment is important, and the success of that treatment is enhanced if that patient is also participating in psychotherapy and receiving the appropriate social services.

That is why this demo is supported by the American Society of Addiction Medicine and the California Medical Association, among others. It is critical that all Americans, regardless of their age or how much money they make, have access to high quality, comprehensive treatment. My bill will strengthen Medicare so we can help seniors address opioid dependence by ensuring they get the care they need.

I also want to thank Ranking Member Pallone and Chairman Walden for their support of this legislation and of our seniors.

Also included in my bill is H.R. 3528, the Every Prescription Conveyed Securely Act, introduced by Representative Katherine Clark from Massachusetts, with the assistance of Representative Mullin.

I want to thank Representative Clark for her hard work to address this crisis by expanding the use of technology to reduce fraudulent prescribing.

Her legislation will direct providers to use electronic prescribing for controlled substances technology for Medicare part D by 2021 to cut down on fraud and overprescribing. Already, seven States have implemented this system in an effort to combat this crisis and keep illicit opioids off the streets.

According to the Department of Justice, most fraudulent opioid prescriptions are obtained either through doctor shopping, forged prescriptions, or theft, all of which can be addressed by an effective electronic prescribing for controlled substances system.

As amended, my bill, H.R. 5605, will improve care for our seniors and help get illegally obtained opioids off the streets.