By Alison Knopf
The bipartisan opioid bill was approved by the Senate and House of Representatives conferees, and is now headed for a full vote in the House. There is much good news: Confidentiality under 42 CFR Part 2 is still protected, and Medicare will cover treatment for all in an OTP (opioid treatment program) with methadone as well as with other approved medications.
42 CFR Part 2
Under the House version, 42 CFR Part 2 would have been replaced by HIPAA, severely limiting patients’ rights to control access to their medical records. Last week the American Medical Association wrote lawmakers, urging them to protect 42 CFR Part 2, saying that without it, patients would hesitate to seek treatment (as the American Association for the Treatment of Opioid Dependence, as well as coalitions of patients, and the Legal Action Center, have said repeatedly).
Medicare
The House version of the opioid bill would provide for complete coverage by Medicare for patients in OTPs, so they would not have to drop out of treatment─or pay for it on their own─once they turn 65. That is how the final bill reads, as well. The Senate version, however, would have provided for only a five-year pilot project.
Next Steps
On September 25 the House of Representatives Ways and Means Committee conferees released the text of H.R. 6 (https://docs.house.gov/billsthisweek/20180924/HR6.pdf). Next, the full House must vote on the bill, which could take place this week. There could still be changes, at the last minute, if major mistakes are found.
Still, these two measures were watched closely by OTP advocates, as the opioid legislation went through Congress.
“Great news: thanks to our collective efforts, the final negotiated opioid package came out of Congress today, including our Medicare policy!” said Jason Kletter, PhD, AATOD legislative committee chair, in a September 26 statement. “This is great news, as it will not only provide a new funding source for our patients, but will also lead to more commercial insurers covering OTP services, given Medicare is a benchmark plan followed by many private carriers.”
The start date for Medicare coverage is January 1, 2020.
Also see:
https://atforum.com/2018/08/opioid-bills-senate-focus-medicare-otps/
https://atforum.com/2018/06/bills-look-at-expanding-medicare-to-cover-otps/
https://atforum.com/2017/12/medicare-reimbursement-otps-cited-briefing/