The House Energy and Commerce Subcommittee on Health held a legislative hearing, ”An Epidemic Within A Pandemic: Understanding Substance Use and Misuse in America,” on April 14 to hear testimony and review legislation aimed at combating substance use disorders.
In their opening statements, full committee Chair Frank Pallone (D-N.J.) and subcommittee Chairwoman Anna Eshoo (D-Calif.) described the COVID-19 pandemic’s impacts on those with substance use disorders, citing statistics on recent increases in overdose deaths. “From August 2019 to August 2020, 88,000 overdose deaths were reported, the highest ever recorded in a 12-month period. The primary driver of these deaths was a dramatic increase in the availability of synthetic opioids derived from fentanyl,” Pallone stated.
Among other related bills, the subcommittee discussed the bipartisan Mainstreaming Addiction Treatment (MAT) Act of 2021 (H.R. 1384), which would suspend the federal “x-waiver” requirement for physicians to prescribe the opioid addiction medication buprenorphine.
“The buprenorphine waiver requirement, or “x-waiver,” has unnecessarily restricted buprenorphine access. Only 5% of medical providers are licensed to prescribe buprenorphine, and the training and associated regulatory barriers to receive the “x-waiver” are onerous and serve as critical barriers to care,” J. Deanna Wilson, MD, MPH, assistant professor of medicine and pediatrics at the University of Pittsburgh School of Medicine, testified.
In her testimony, Acting Director of the Office of National Drug Control Policy (ONDCP) Regina LaBelle, JD, noted that “removing unnecessary barriers to prescribing buprenorphine” was one of several actions the Biden administration would pursue. The Trump administration announced a suspension of the waiver requirement just before the president left office, but the HHS reversed course shortly afterward, citing that the guidelines were issued “prematurely” [refer to Washington Highlights, Feb. 5]. The AAMC has supported suspending the “x-waiver” requirement [refer to Washington Highlights, June 5, 2020].
LaBelle outlined additional Biden administration priorities to address substance use disorders, including advancing racial equity in approaching drug policies, enhancing harm reduction and prevention efforts, reducing the supply of illicit substances, expanding the addiction workforce, and expanding access to recovery support services.
Regarding parity in insurance coverage, LaBelle added that the administration would “take steps to ensure that health insurers and group health plans that offer mental health and substance use treatment and services provide the same level of benefits for those services that they do for other medical care.” She added that these steps will include the formation of a working group with health care insurers and employers to “promote full compliance of the Mental Health Parity and Addiction Equity Act to eliminate discriminatory barriers to mental health and substance use disorder services.”
LaBelle also testified that the ONDCP will explore making permanent flexibilities implemented during the public health emergency to support those with mental health and substance use disorders, “as well as evaluating the continuation of Medicaid and Medicare reimbursements for these telehealth services.”