The White House Commission on Combating Drug Addiction and the Opioid Crisis has presented its interim report to President Trump. Among the highlights, the Commission calls for better alignment of patient privacy laws to enable easier sharing of health information for patients with a history of substance use disorders (SUD). Netsmart has been engaged in ongoing legislative and regulatory advocacy on this issue. The current complicated consent processes make it difficult for people with opioid addiction or other SUDs to share full health information with their doctors, negating the opportunity to receive fully-informed, integrated, coordinated care.
Some other selected recommendations from the Commission impacting Netsmart clients include:
- Better align, through regulation, patient privacy laws specific to addiction with the Health Insurance Portability and Accountability Act (HIPAA) to ensure that information about SUDs be made available to medical professionals treating and prescribing medication to a patient. This could be done through the bipartisan Overdose Prevention and Patient Safety Act/Jessie’s Law. The report says, “Making it administratively difficult for providers to share information has ill-effects on patients in both physical and behavioral health settings, by restraining physicians’ ability to make informed healthcare decisions.”
- Enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) with a standardized parity compliance tool to ensure health plans cannot impose less favorable benefits for mental health and substance use diagnoses versus physical health diagnoses. The report states: “But not providing real parity is already illegal. The Commission urges (the White House) to direct the Secretary of Labor to enforce this law aggressively and to penalize the violators.”
- Rapidly increase treatment capacity. Grant waiver approvals for all 50 states to quickly eliminate barriers to treatment resulting from the federal Institutes for Mental Diseases (IMD) exclusion within the Medicaid program. This component of the Social Security Act prohibits federal Medicaid funds from reimbursing services provided in an inpatient facility treating “mental diseases” (including SUDs) that have more than 16 beds. This exclusion makes states entirely responsible for Medicaid-eligible patients in inpatient treatment facilities, including patients undergoing withdrawal management in addiction treatment facilities rather than hospitals. According to the Commission, granting waivers will immediately open treatment to thousands of Americans in existing facilities in all 50 states.
- Immediately establish and fund a federal incentive to enhance access to Medication Assisted Treatment (MAT). Require that all modes of MAT are offered at every licensed MAT facility and that those decisions are based on what is best for the patient. Partner with the National Institutes of Health (NIH) and the industry to facilitate testing and development of new MAT treatments.
- Provide model legislation for states to allow naloxone dispensing via standing orders, as well as requiring the prescribing of naloxone with high-risk opioid prescriptions; we must equip all law enforcement in the U.S. with naloxone to save lives.
- Provide federal funding and technical support to states to enhance interstate data sharing among state-based prescription drug monitoring programs (PDMPs) to better track patient-specific prescription data and support regional law enforcement in cases of controlled substance diversion. Ensure federal healthcare spending, including Veteran’s Hospitals, participate in state-based data sharing.
Click here for the full Commission interim report.