Opiate Addiction Treatment

Regulation Update on Opiate Addiction Treatment – July 2016

This month saw historic advancements in providing treatment to people suffering from pain drug dependence and heroin addiction. First, on July 6th, the Department of Health and Human Services (HHS) issued a final rule to increase access to Medication Assisted Treatment (MAT) with buprenorphine. Then, on July 13th, the Senate passed the Comprehensive Addiction and Recovery Act (CARA), which would strengthen prevention, treatment and recovery efforts, largely by empowering medical professionals and law enforcement officials with more tools to help people suffering from drug addiction.

HHS Ruling (July 6th, 2016)

This Rule will become effective on August 5, 2016. This Rule will increase the number of patients that practitioners who focus on addiction treatment can treat with buprenorphine from 100 to 275 in their third year of treating patients. Thus, the number of patients certified practitioners can treat are the following:

• Year 1 – 30 patients
• Year 2 – 100 patients
• Year 3 and on – 275 patients

Under routine conditions, a practitioner would qualify for the higher limit in one of two ways:

• by possessing subspecialty certification in addiction medicine or addiction psychiatry, or
• by practicing in a Qualified Practice Setting (QPS) as defined in the rule. A QPS is practice that:

o can treat patients in after hours, includes case-management services including behavioral health services;
o use health information technology such as electronic health records;
o participates in the prescription drug monitoring program (PDMP), and;
o has the ability to receive third party payments (such as insurance or federal funding)

The purpose of offering the 275 patient limit to practitioners in these two categories is to recognize the benefit offered to patients through people trained and educated in addiction treatments and the higher level of direct service and care coordination that comes from a qualified practice setting.

To read the entire HHS ruling click here

Comprehensive Addiction and Recovery Act (July 13th, 2016)

The Comprehensive Addiction and Recovery Act (CARA) was passed by the Senate in a monumental 92 to 2 vote. CARA is a compromise between the House and the Senate, combining 18 measures that passed the House in May, including the “Lali Bill” developed in conjunction with the Live4Lali organization, and the Senate’s more comprehensive legislation, which was approved in March. Now passed by the Senate, the bill will be sent to the President to be signed into law. The expectation is that it will be sent to him in the coming weeks.

Some of the highlights of CARA are:

• Treating substance use disorder as a chronic illness rather than a criminal offense;
• Expands education and prevention efforts;
• Strengthens prescription drug monitoring programs;
• Grants for expanded treatment and education;
• Increases first responder access to naloxone, and;
• Allows nurse practitioners and physician assistants to prescribe buprenorphine with some restrictions.

To read the entire CARA bill click here