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HHS tackles opioid epidemic


HHS is taking formal steps to address opioid addiction, a widely recognized national public health crisis. Find out the policy changes.

HHS is taking formal steps to address opioid addiction, a widely recognized national public health crisis.

These steps include expanding access to buprenorphine-a drug used to treat opioid addiction-a proposal to eliminate any potential financial incentive for doctors to prescribe opioids based on patient experience survey questions, and a requirement for Indian Health Service prescribers and pharmacists to check state Prescription Drug Monitoring Program (PDMP) databases before prescribing or dispensing opioids for pain, according to an HHS press release. HHS is also launching over a dozen new scientific studies on opioid misuse and pain treatment and soliciting feedback to improve and expand prescriber education and training programs.

As the nation’s opioid epidemic continues to intensify, consider joining trailblazers from health plans, pharmacies and healthcare companies at CBI’s inaugural Prescription Drug Monitoring Programs. This summit will focus on the crucial elements of managing how drugs are prescribed, dispensed and reimbursed.


“The proposed rule, published in the Federal Register, includes a policy change that would remove patient pain assessment survey questions from figuring into Medicare reimbursements,” according to Managed Healthcare Executive Joel V. Brill, MD, chief medical officer at Predictive Health. “Expanding access to medication assisted treatment is a critical component of the rule finalized by the Substance Abuse and Mental Health Services Administration [SAMHSA]. Practitioners who have had a waiver to prescribe buprenorphine for up to 100 patients for a year or more can now obtain a waiver to treat up to 275 patients.” 

The policy change is in response to critics who have called for changes to The Joint Commission’s pain management standards and to the federal government’s patient surveys used in hospitals. They say doctors were pressured to overprescribe opioid painkillers because patients are asked about their pain levels on satisfaction surveys (known as Hospital Consumer Assessment of Healthcare Providers and Systems or HCAHPS) that help determine federal reimbursement payments. That pressure helped to contribute to the country’s current opioid epidemic, they claim.


“This ruling is not likely to have an immediate impact on managed care executives, but it does appear to be part of a sea change on how the system prescribes and manages opioids,” says Curant Health Chief Operating Officer Marc O’Connor. “Furthermore, this decision mitigates the perception that there is financial incentive to over-prescribe these kinds of medications. However, the financial effects will take years to assess.”

In March 2015, the

HHS Opioid Initiative

was launched and is focused on three key priorities:

• Opioid prescribing practices to reduce opioid use disorders and overdose

• Expanded use and distribution of naloxone

• Expansion of Medication-assisted Treatment (MAT) to reduce opioid use disorders and overdose

In March 2016 HHS released a National Pain Strategy, outlining the federal government’s first coordinated plan for reducing the burden of chronic pain that affects millions of Americans. The National Pain Strategy is a roadmap toward achieving a system of care in which all people receive appropriate, high quality and evidence-based care for pain.


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