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ADVOCACY SPOTLIGHT


Opioid Crisis Response Continues Congress and ASCA work to raise awareness and curb use BY JEFF EVANS


According to an esti- mate from the US Drug Enforcement Administra- tion, more than 72,000 Americans died in 2017


from drug overdoses. Preliminary data show 49,060 of these deaths were related to opioids—an increase from 42,249 in 2016. The 2016 figure was five times higher than the 1999 figure. In 2018, the US Congress devoted countless hours crafting legislation to help address the epidemic. ASCA worked alongside these efforts to help raise awareness of the opioid crisis. During a special signing event on October 25, President Donald Trump signed into law the Substance Use-Dis- order Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (H.R. 6). The president’s signature came three weeks after the US Senate passed the legislation 98 to 1, and about a year after he first declared the opioid epi- demic a public health emergency. This bill combines US House of Representa- tives and Senate legislation and includes policy related to Medicaid, Medicare, telehealth, the Federal Drug Adminis- tration, research programs, community health services and health information technology, among other issues. In a related press release from the House Energy and Commerce Com- mittee, then Chairman Greg Walden (R-OR) and then Health Subcommittee Chairman Mike Burgess, MD (R-TX) stated “while there is still much work to be done, this historic effort will undoubtedly save lives and put fami- lies and communities across our coun- try on the road to recovery.” A key provision of the SUPPORT


Act, the Dr. Todd Graham Pain Man- agement, Treatment, and Recovery Act


24 ASC FOCUS FEBRUARY 2019 | ascfocus.org


of 2018, directs the US Department of Health and Human Services (HHS) to review and adjust payments under the Medicare Hospital Outpatient Pro- spective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System to “avoid financial incentives to use opioids instead of non-opioid alternative treatments.” If necessary, HHS will revise payments through rulemaking. Several other Medicare provisions in the bill might impact ASCs: ■■


Medicare opioid safety—HHS will establish an action plan, with subse- quent reports to Congress, on recom- mendations for changes under Medi- care and Medicaid to prevent opioid addictions and enhance access to medication-assisted treatment.


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Electronic prior authorization for covered Medicare Part D drugs— HHS will establish a standard and secure electronic prior authoriza- tion system for prescribing covered Medicare Part D drugs no later than January 1, 2021.


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Medicare Payment Advisory Commission (MedPAC) report— MedPAC will submit a report to Congress on: (1) how Medicare pays for pain management treatments in


GET INVOLVED IN ASC ADVOCACY


ASCA’s regulatory and legislative successes are dependent on the advocacy efforts of ASCA members. Get involved by participating in ASCA’s National Advocacy Day, hosting a facility tour or celebrating National ASC Month in August.


ascassociation.org/ grassroots


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inpatient and outpatient hospital set- tings; (2) current incentives for pre- scribing opioid and non-opioid treat- ments under Medicare’s inpatient and outpatient prospective payment systems; and (3) how opioid use data is tracked and monitored through Medicare claims data.


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Pain management study—HHS, in consultation with stakeholders, will submit a report to Congress on how to improve reimbursement and coverage for multi-disciplinary, evidence-based, non-opioid chronic pain management.


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Review of quality measures related to opioids—Within six months, HHS will convene a Technical Expert Panel (TEP) to review quality measures related to opioids and opioid use disor- ders. The TEP will: (1) review existing measures; (2) identify gaps in quality measurement and prioritize develop- ment in gap areas; and (3) make rec- ommendations regarding revisions of existing measures, development of new measures and recommenda- tions for inclusion of such measures in value-based payment programs.


Reducing opioid use in surgical set- tings—Within six months, HHS will convene a TEP consisting of medical and surgical specialty societies and hospital organizations to recommend best practices for pain management in surgical settings. HHS must issue a public report within one year.


Updates to opioid prescribing guidance—Within six months, the Centers for Medicare & Medicaid Services (CMS) will post online all opioid prescribing guidance pub- lished after January 1, 2016, appli- cable to Medicare beneficiaries. Two important provisions—origi- nally included in House legislation—


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