Mr. Chair, I have an amendment at the desk. Mr. Chair, I rise in support of my amendment to H.R. 6. I am grateful for the opportunity to speak about it. My amendment strikes language that would expand the classes of healthcare workers who…
Mr. Chair, I have an amendment at the desk.
Mr. Chair, I rise in support of my amendment to H.R. 6. I am grateful for the opportunity to speak about it.
My amendment strikes language that would expand the classes of healthcare workers who would be authorized to dispense narcotics for narcotic treatment.
Let me be clear at the outset. H.R. 6 is, in large part, a great bill; however, as currently written, it allows nurse specialists, nurse midwives, and nurse anesthetists to prescribe buprenorphine. I believe this is a significant and impulsive expansion of prescribing authority.
Allowing more providers with less clinical experience to provide buprenorphine, a highly addictive opioid, opens up dangerous new potential for increased opioid abuse. The point of H.R. 6 is to decrease opioid abuse, but this provision increases the potential for abuse and vastly increases the supply of a dangerous opioid that is one of the major causes of opioid overdose and death in Europe.
Mr. Chair, I appreciate the opportunity to bring these concerns to light in this amendment.
Mr. Chair, I include in the Record a letter in support of my amendment from The OTP Consortium.
The OTP Consortium,
June 19, 2018.
Hon. Greg Walden,
Chairman, Committee on Energy and Commerce, House of
Representatives, Washington, DC.
Hon. Kevin Brady,
Chairman, Committee on Ways and Means,
House of Representatives, Washington, DC.
Hon. Frank Pallone, Jr.,
Ranking Member, Committee on Energy and Commerce, House of
Representatives, Washington, DC.
Hon. Richard Neal,
Ranking Member, Committee on Ways and Means, House of
Representatives, Washington, DC.
Dear Chairmen Walden and Brady and Ranking Members Pallone
and Neal: On behalf of the Opioid Treatment Program (OTP)
Consortium we would like to offer our support for H.R. 6, the
Substance Use-Disorder Prevention that Promotes Opioid
Recovery and Treatment (SUPPORT) for Patients and Communities
Act. In particular, we strongly support Section 207 which
would provide Medicare beneficiaries with lifesaving
Medication-Assisted Treatment (MAT) for opioid use disorder
(OUD) in the highly-effective OTP setting. This policy was
introduced by Ranking Member Neal and Congressman George
Holding as part of H.R. 5776, the Medicare and Opioid Safe
Treatment (MOST) Act of 2018. The OTP Consortium is comprised
of nearly 350 OTPs across the country that provide care to
more than 140,000 patients daily in 37 states, including at
our 22 facilities in Massachusetts, 16 facilities in Texas,
nine facilities in Oregon, and two facilities in New Jersey.
OTPs are highly-regulated, highly-structured, comprehensive
treatment programs that provide MAT--which the National
Institutes of Health states is the most effective solution to
treat OUD. OTPs are the only provider where patients are
guaranteed to receive MAT--including individual and group
counseling, random toxicology screens, medication, and other
supportive services such as case management, primary care,
mental health services, HIV and Hepatitis C testing and more.
Medicare beneficiaries have the highest and fastest growing
rate of OUD, yet they do not currently have coverage for the
most effective form of treatment--H.R. 6 provides such
coverage. More than 300,000 Medicare beneficiaries have been
diagnosed with OUD--your legislation could end up saving
their lives and many more. Medicare hospitalizations due to
complications caused by opioid abuse or misuse increased 10%
every year from 1993 to 2012--your bill would help reverse
this alarming trend.
We do, however, have concerns about the policies contained
in Section 303. While we are pleased that the 275-patient
threshold was not codified, we do not support expanding or
making permanent buprenorphine prescribing authority to non-
physician providers before policymakers can fully analyze the
data resulting from the critical questions asked in
subsection (e). Americans need effective treatment and
decades of evidence and outcomes show that medication simply
assists the other treatment interventions. Medication should
never be the sole aspect of treating SUD--thus the term
Medication-Assisted Treatment. Office-based practices that
focus on medication alone run the risk of becoming the next-
generation pill mill. We hope that Congress will revisit
office-based buprenorphine prescribing thresholds once this
quality assessment has been completed and it can be
determined whether or not patients are indeed truly receiving
MAT in these settings. Improving access to buprenorphine is
important, but it must be paired with the evidence-based MAT
services that are proven to lead to recovery.
We support H.R. 6 and stand ready to work with you see that
this critical Medicare OTP benefit is signed into law,
without delay.
Sincerely,
Peter Morris,
Division President, Acadia Healthcare.
Alex Dodd,
CEO, Aegis Treatment Centers, LLC.
David White, Ph.D.,
CEO, BayMark Health Service.
Jay Higham,
CEO, Behavioral Health Group.
John Steinbrun,
CEO, New Season.
Mr. Chair, I reserve the balance of my time.
Mr. Chair, I yield 1 minute to the gentleman from Tennessee (Mr. Roe), the chairman of the Veterans' Affairs Committee.
I yield the gentleman an additional 1 minute.
Mr. Chairman, I yield 1 minute to the gentleman from Kansas (Mr. Marshall).
Mr. Chair, buprenorphine was introduced in Finland in 1997, and now it has become the most widely-abused opioid in that country. Buprenorphine can kill people. It does kill people. And office-based practices involving merely prescribing buprenorphine run a large risk of harming patients, not helping them to recover.
In closing, I want to thank you for working with me on this amendment, and I thank Chairman Walden for his gracious commitment to continue to examine.
I yield back the balance of my time
Mr. Chairman, I ask unanimous consent to withdraw my amendment.