CMS Announces New OUD Treatment Demo to Drive Value

The Centers for Medicare & Medicaid Services’ Center  for Medicare and Medicaid Innovation (CMMI) announced on Thursday the launch of the Value in Opioid Use Disorder Treatment demonstration. Over the course of four years, the demo seeks  “increase access of applicable beneficiaries to opioid use disorder treatment services, improve physical and mental health outcomes for such beneficiaries, and to the extent possible, reduce [Medicare program expenditures].” The demo creates two new payment pathways for OUD services focused on a per-beneficiary-per-month care management fee and a performance-based incentive.

The ViT demo will assess whether such intervention will “reduces hospitalizations and emergency department (ED) visits; increases use of medication assisted treatment (MAT) for OUD; improves health outcomes for individuals with OUD, including reducing the incidence of infectious diseases such as Human Immunodeficiency Virus (HIV) and hepatitis C (HCV); reduces deaths from opioid overdose; reduces utilization of inpatient residential treatment; and reduces Medicare program expenditures to the extent possible.”

Pursuant to Section 6042 of the SUPPORT Act, up to 20,000 beneficiaries of interest will be enrolled in Medicare Part A and Part B (and not Medicare Advantage; but may be dually eligible) with a current diagnosis of an opioid use disorder. Entities and individuals enrolled in the Medicare program may participate in the demo.

The request for applications is open through January 3, 2021 and is anticipated to launch the performance period around April 1, 2021.

Articles & Resources

CMS Newsroom – Value in Opioid Use Disorder Treatment Demonstration

LINK to the Request for Applications Package

House Passes Several Opioid-related Bills via Voice Vote

  • State Opioid Response Grant Authorization Act of 2020 (H.R. 2466), extending the SOR grant program through FY2026 at a rate of $1.5 billion annually;
  • Easy Medication Access and Treatment for Opioid Addiction Act” or the “Easy MAT for Opioid Addiction Act (H.R. 2281), extending the allowable duration of narcotic drugs to be dispensed for maintenance or detox treatment to three days;
  • Block, Report, And Suspend Shipments Act of 2020 (H.R. 3878), requiring drug manufacturers and distributors to conduct due diligence around suspicious orders of controlled substances and decline fills if resolution isn’t met;
  • Debarment Enforcement of Bad Actor Registrants Act of 2020 (H.R. 4806), prohibiting an individual from registering to manufacture or dispense controlled substance pursuant to a previous suspension;
  • Ensuring Compliance Against Drug Diversion Act of 2019 (H.R. 4812), limiting the transfer of DEA controlled substance registrations, particularly in the instance of a registrant death, business termination or surrendering of an existing registration.

The FENTANYL Results Act (H.R. 7990), co-sponsored by Representatives David Trone (D-MD) and Michael McCaul (R-TX) was also passed unanimously by the House on Wednesday.

It is unclear of the timeline for the Senate to take up these bills as part of the lame duck agenda, but the CEPOP team will track closely and report back on any status updates.

Articles & Resources

House Committee on Energy & Commerce – Pallone and Eshoo on House Passage of Ten Health Care Bills

Law360 – House Passes Bipartisan Bills to Fight Opioid Crisis

USPS Report Highlights Efforts to Crack Down on Illicit Opioids in the Mail

On Wednesday, the USPS Office of Inspector General released an eighteen page report outlining the agency’s efforts to handle and interdict packages suspected to contain illicit drugs. Over the course of the last several years, the agency has stood up several initiatives to educate parcel workers around handling of suspicious packages and removal of dangerous goods from circulation. The report identified several areas in which USPIS could enhance its handling protocol including reporting requirements.

Between FY18 and FY19, the agency noted a substantial increase in the amount of illicit drugs interdicted from the postal system, nearly doubling to 95,488 pounds (including marijuana, methamphetamines, cocaine, controlled substances, and steroids). Over the course of two years USPIS recorded more than 66,000 packages containing illicit drugs.

View the report.

Articles & Resources

USPS OIG – U.S. Postal Inspection Service’s Oversight of Mail Suspected of Containing Illicit Drugs at Postal Facilities

LINK to OIG Report

What We Read Last Week

Several articles were published last week pertaining to the opioid epidemic, covering a variety of different components of the issue. Links to relevant articles are provided below.

Articles & Resources

Forbes – Pandemics and Overdoses: COVID-19 May Worsen Our Opioid Epidemic

NPR – ‘We Are Shipping to the U.S.’: Inside China’s Online Synthetic Drug Networks

Kaiser Health News – Patients Struggle to Find Prescription Opioids After NY Tax Drives Out Suppliers

NPR – Street Fentanyl Surges in Western U.S., Leading to Thousands of Deaths

STAT News – To Maintain Opioid Sales, Purdue was Advised to Pay Rebates to Insurers for Each Overdose

Law360 – Purdue Pharma Gets Court Approval for $8B Deal with Feds

Law360 – Philly Injection Site Violates Federal Law, 3rd Circ. Told

The Gainesville Sun – At-Home Medication Disposal to Address Rise in Overdoses

Deseret News – How American Muslins Are Tackling Substance Abuse Among the Faithful

NIH Heal Initiative – Designing Alternatives to Morphine After Surgery

Federal Register – Agency for Healthcare Research and Quality: Supplemental Evidence and Data Request on Integrated Pain Management Programs

New York State Office of Addiction Services and Supports – NYS OASAS Announces Approximately $24 Million in Funding to Expand Addiction Treatment Facilities in Southern Tier and Finger Lakes Regions

U.S. Attorney for the Southern District of New York – Doctor And Office Manager Charged For Illegally Distributing Oxycodone From Midtown Manhattan Practice

U.S. Attorney for the Western District of Pennsylvania – PA Pharmacist Pleads Guilty and is Sentenced for Unlawfully Dispensing Painkillers

U.S. Attorney for the Eastern District of Louisiana – Mandeville Woman Pleads Guilty To Distributing Prescription Medication

U.S. Attorney for the Central District of California – Former O.C. Physician Assistant Admits to Knowingly Writing Opioid Prescriptions to Dealers Who Later Sold the Drugs on the Street

This Week’s Calendar

Members of Congress are back in district this week for the Thanksgiving holiday. As such, there are no opioid-related hearings or markups to be held this week. We have, however, included several virtual events that may be of interest to Policy Report recipients. In the instance that there are any changes to the schedule for this week, we will make additional information available.

  • NIH Interagency Pain Research Coordinating Committee
    IPRCC Meeting and Member Updates (link to agenda)
    Monday, November 23rd, 11:00am – 5:00pm; https://videocast.nih.gov/
  • National Academies of Medicine: Forum on Mental Health and Substance Use Disorders
    Mental Health and Substance Use Disorders in the Era of COVID-19: With a Special Focus on the Impact of the Pandemic on Communities of Color
    Monday, November 23rd, 1:00pm – 3:00pm; Register Here

Questions about the above content can be directed to [email protected]