WASHINGTON — A key Senate committee is moving ahead with legislation that would theoretically provide more programs — and more funds — to combat the opioid crisis, scheduling a mark-up of the proposal on April 24.
The US Senate Committee on Health, Education, Labor and Pensions (HELP) will tweak the proposal that day and seek a floor vote soon after, said panel chairman Lamar Alexander (R-TN) at a hearing today.
The committee was meeting to discuss the Opioid Crisis Response Act of 2018, a work-in-progress that will likely be amended before the April 24 session, and potentially after, as the House Energy and Commerce Committee is also preparing some 34 pieces of legislation addressing how Medicare and Medicaid are responding to the opioid crisis.
The Energy and Commerce committee also met today, as did two other congressional panels, the House Oversight and Government Reform Committee and the Senate Judiciary Subcommittee.
None of the panels have suggested how they would pay for the new proposals — a key missing piece, as Congress has already passed a major spending bill for the year.
The HELP committee’s Opioid Crisis Response Act would give new authorities — and possibly, new funding — to six federal agencies, and includes 29 proposals. Among those is a measure designed to give the National Institutes of Health “flexibility” to develop a nonaddictive pain therapy. “I see non-addictive painkiller really as the Holy Grail of solving the opioid crisis,” said Alexander at the hearing.
The proposal also would clarify the US Food and Drug Administration’s authority to require manufacturers to package certain medications into time-limited blister packs and provide a safe means of disposal. Prescription drug monitoring programs would be streamlined to encourage sharing among states and increase sharing of substance use history data.
The Senate plan also “addresses the need to help our strained behavioral health workforce so that patients can get the care they need even if they live too far from a doctor’s office, by expanding loan repayment to behavioral health providers who practice in underserved areas,” said Sen. Patty Murray (D-WA) at the hearing.
The recently signed 2018 federal budget allows the National Health Service Corps participants who are substance use disorder counselors to be eligible for loan repayment. The HELP proposal would extend the program.
Telemedicine, Prescribing Privileges
The Substance Abuse and Mental Health Services Administration would also be given new grant authority to let health providers treat addiction with telemedicine and other new technologies, Murray said.
The committee is also aiming to permanently give nurse practitioners (NPs) and physician assistants (PAs) the ability to prescribe medication-assisted treatment (MAT). Both NPs and PAs were given MAT prescribing privileges by the Comprehensive Addiction and Recovery Act, which was signed into law in July 2016. Those privileges are due to end on October 1, 2021, according to the American Society of Addiction Medicine.
Other Senators on the panel said they’d be asking Alexander to incorporate some additional ideas into the final legislation that gets reported out of the committee.
Sen. Susan Collins (R-ME) said she’s looking to include a bill she’s developing with Senators Elizabeth Warren (D-MA), Maggie Hassan (D-NH), and Marco Rubio (R-FL) that would give hospice staff, including nurses, physicians, and paramedics, the ability to dispose of unused medications left over at the home after a patient’s death.
Warren wants to see action on her proposal to educate clinicians and patients about the ability to partially fill an opioid prescription when it is first written. The law is already on the books, but is not being properly or fully implemented, Warren said.
Hassan said she’s working on a bill that would find a way to provide grants to medical schools and residency programs to train students and residents in providing medication-assisted treatment. Several schools have begun such programs, including Brown University’s Alpert Medical School,which provided training to 30 students in the class of 2018. Those students could then apply for a waiver immediately after graduation.
Sometime after the end of April, the committee will ask Senate Majority Leader Mitch McConnell to schedule a vote on the Senate floor, Alexander said.
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