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  • Washington Highlights

    House, Senate Committees Advance Separate Bills Addressing Opioid Crisis; House Package Requires State Reporting of Medicaid Expenditures for GME Legislation

    Tannaz Rasouli, Sr. Director, Public Policy & Strategic Outreach
    Len Marquez, Senior Director, Government Relations

    The Senate Health Education, Labor, and Pensions (HELP) Committee April 24 voted 23-0 to advance The Opioid Crisis Response Act (S.2680). The Senate’s opioid legislation includes over 40 provisions from 38 different senators [see Washington Highlights, April 20]. Similarly, the House Energy and Commerce Health Subcommittee April 25 advanced its own opioid package, consisting of 57 bills, including a draft bill that would make changes to the Medicaid Graduate Medical Education (GME) program.

    The draft “Medicaid Graduate Medical Education Transparency Act” was passed out of the House subcommittee on a party line vote (18-10) during Wednesday’s markup. Full committee markup has not yet been scheduled, but could occur in the next few weeks. The legislation would require state agencies to report the total amount of Medicaid GME expenditures on a fee-for-service and managed care basis, the number of full-time equivalent residents in a variety of specialties, and accreditation requirements, among other items [see Washington Highlights, April 13]. During the markup, Ranking Member Frank Pallone (D-N.J.) expressed his concern with the discussion draft, “This is really not an opioids bill. While there is obviously a need for more substance abuse and mental health providers – primary care and other types of providers across the country – the bill we are considering does nothing to address these physician shortages or increase treatment capacity for substance use disorders.”

    Among the other bills the Energy and Commerce subcommittee approved was a bill authored by Rep. Bill Johnson (R-Ohio) titled the TEACH to Combat Addiction Act of 2018 (H.R. 5261). It would authorize support for educational “Centers of Excellence” to enhance substance use disorder (SUD) treatment and pain management education of health professionals. The subcommittee adopted an amendment in the nature of a substitute offered by Subcommittee Chair Michael Burgess (R-Texas), before approving the bill by unanimous consent.

    The subcommittee also approved the ACE Research Act (H.R. 5002), authored by Reps. Debbie Dingell (D-Mich.) and Fred Upton (R-Mich.). The bill would provide the National Institutes of Health (NIH) with “other transactions authority” to support “high impact cutting-edge research that fosters scientific creativity and increases fundamental biological understanding leading to the prevention, diagnosis, or treatment of diseases and disorders, or research urgently required to respond to a public health threat.” The Senate HELP package includes the language as well.

    Additionally, the subcommittee passed the Substance Use Disorder Workforce Loan Repayment Act of 2018 (H.R. 5102), sponsored by Reps. Katherine Clark (D-Mass.) and Hal Rogers (R-Ky.), which would “offer student loan repayment of up to $250,000 for participants who agree to work as a SUD treatment professional in areas most in need of their services. Eligible professions include physicians, registered nurses, social workers, and other behavioral health professionals."

    On the Senate side, members of the Senate HELP Committee offered amendments to The Opioid Crisis Response Act prior to its passage, including a manager’s amendment offered by HELP Committee Chair Lamar Alexander (R-Tenn.).

    During the committee markup, Sen. Maggie Hassan (D-N.H.) discussed an amendment she offered, which would seek to “help more physicians get waivers [to prescribe buprenorphine] and increase access to medication-assisted treatment.” The amendment, which the committee adopted, authorizes $24 million of grant funding through the Department of Health and Human Service (HHS) for medical schools and teaching hospitals to integrate content that physicians are required to complete to be able to prescribe buprenorphine. The language is pulled from the “Enhancing Access to Addiction Treatment Act of 2018” (S. 2711), which Sen. Hassan introduced with Sen. Rob Portman (R-Ohio) on April 19. The bill also would allow graduates of medical schools and residency programs that included content “on treating and managing opiate-dependent patients” to be certified to prescribe buprenorphine without completing the additional training currently required. That component of the bill was included in the manager’s amendment adopted by the full committee.

    Similarly, the committee approved an amendment offered by Sen. Michael Bennet (D-Colo.), which would authorize $25 million of grant funding from HHS for hospitals that incorporate alternative to opioids for pain management.