House Lawmakers Introduce CARA 3.0 to Increase Funding for Evidence-Based Addiction and Recovery Programs

Last week, Representatives David Trone (D-MD-06), Annie Kuster (D-NH-02), Brian Fitzpatrick (R-PA-01), and Jaime Herrera Beutler (R-WA-03), Tim Ryan (D-OH-13), David McKinley (R-WV-01), Paul Tonko (D-NY-20), and Dave Joyce (R-OH-14) introduced the bipartisan Comprehensive Addiction and Recovery Act (CARA) 3.0 Act. CARA 3.0 would increase funding authorization levels for original CARA and CARA 2.0 evidence-based prevention, treatment, recovery, and criminal justice programs. CARA 3.0 includes many new policy changes, including conducting new research on non-opioid alternatives and long-term treatment outcomes, prohibiting states from requiring prior authorization for medication assisted treatment (MAT) under Medicaid, removing the limit on the number patients a physician can treat with buprenorphine and methadone, and permanently allowing providers to prescribe MAT without a prior in-person visit. The bill would also allow increase access to telehealth services, expand recovery housing, establish a pilot program for rural and underserved areas to examine the use of mobile methadone clinics, and establish a National Commission for Excellence in Post-Overdose Response.

The original CARA became law in 2016, and several key provisions were included in CARA 2.0 as part of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act enacted in 2018. In a press release, Representative Trone said, “over the past year, our nation’s substance use treatment providers have been hard at work serving those in need, often transitioning to telehealth appointments and mobile clinics to avoid lapses in treatment and access. As we emerge from this pandemic, it is critical we provide doctors, nurses, and health care workers the support they need for prevention, education, research, treatment, and recovery. I’m proud to join my colleagues in introducing CARA 3.0 to modernize our nation’s approach to the addiction crisis, and I look forward to advancing this much-needed legislation to help save lives.” Companion legislation was introduced in the Senate in March.

Articles & Resources

Representative David Trone – Trone Introduces Bipartisan, Bicameral Legislation to End the Addiction Epidemic and Increase Access to Treatment, Prevention, and Recovery Resources

CARA 3.0

DEA Publishes Final Rule Expanding Flexibilities for Mobile Treatment Programs

On June 28, the Drug Enforcement Administration (DEA) published their final rule authorizing DEA registered narcotics treatment programs (NTPs) that want to dispense medications for opioid use disorder (OUD) via a mobile unit to add these mobile units to their existing registrations without requiring a separate registration. The final rule lifts a 14-year-old moratorium on registering mobile treatment units that was put in place in 2007 to prevent diversion. Proponents welcoming the final rule say that the elimination of a separate registration will decrease operation expenses and will allow registrants to expand treatment services to suburban, rural, and underserved areas, and to correctional facilities. DEA officials noted that the mobile NTP services will be reimbursed by state Medicaid and Medicare, and stakeholders are now eyeing how individual states will implement the rule requirements. In an announcement on the DEA website, DEA Assistant Administrator for Diversion Control Tim McDermott said “the Administration, DOJ, DEA, HHS, among many others, are squarely focused on efforts to improve the use of medication-assisted treatment in order to reduce overdose deaths and help those with opioid-addictions recover. Today’s action sends a very important message that we support the use of medication-assisted treatment for opioid use disorder and are using all the tools at our disposal to make treatment options available to anyone in need of them, anywhere in the country.” The final rule will take effect on July 28 of this year.

Articles & Resources

Final Rule

Inside Health Policy – DEA Lifts Long-Standing Mobile Addiction Treatment Unit Moratorium

DEA – DEA Finalizes Measures to Expand Medication-Assisted Treatment

Bipartisan Legislation Would Inform Providers about Patient Overdoses and Support Overdose Victims

Last week, Representatives Jaime Herrera Beutler (R-WA-03), Markwayne Mullin (R-OK-02), David Trone (D-MD-06), Brian Fitzpatrick (R-PA-01), Annie Kuster (D-NH-02), and G.K. Butterfield (D-NC-01) introduced the Improving Medicaid Programs’ Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act. The IMPROVE Addiction Care Act would require state Medicaid programs to notify providers about their patients’ opioid overdoses and would connect survivors of opioid overdoses to treatment services and programs. In a press release, Representative Mullin said, “in order to safely and effectively treat a patient who has previously experienced a non-fatal overdose, it is critical prescribers have access to their patient’s overdose history in order to prevent it from happening again. This legislation breaks down barriers to help Medicaid beneficiaries get access to the treatment they need and ensure providers have a clear picture of the patient’s history with opioid-related overdoses. We all know someone who has been affected by the opioid epidemic, whether it’s a family member or loved one, and it’s going to take all of us working together to put an end to this crisis.”

Articles & Resources

Representative Herrera Beutler – Bennet, Collins Introduce Legislation to Significantly Expand Opioid, Substance Use Training for Providers Nationwide

IMPROVE Addiction Care Act

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

ABC 7News – An Addicted in America special

Associated Press – J&J agrees to pay $230M to settle New York opioid claim

Associated Press – Opioid makers, distributors go on trial in New York

Bloomberg Government – Justice Department Reports Record Number of Health Fraud Cases

Bloomberg Government – New York Opioid Settlement Funds to Go to Prevention, Support

DEA – DEA Washington Division Issues Warning: “One Pill Can Kill”

Law360 – 3 Pharmacies Cut From NY Opioid Trial, CVS Reaches Deal

Law360 – Opioids Were Mission Of ‘Mercy’ For Doctors, Expert Testifies

Representative Annie Kuster – NH Delegation Announces $500,000 Over Five Years Heading to NH to Address the Substance Use Disorder Epidemic

Representative Vern Buchanan – Buchanan, Pappas Demand Action on Bipartisan Legislation to Crack Down on Deadly Fentanyl

The New York Times – Helping Drug Users Survive, Not Abstain: ‘Harm Reduction’ Gains Federal Support

The New York Times – Major Trial Against Opioid Suppliers Begins in New York

The Pew Charitable Trusts – Midwest Initiative Seeks to Reduce Opioid Use in Rural and Tribal Communities

U.S. Attorney’s Office for the District of Massachusetts – Dominican National Sentenced for Fentanyl and False Identity Crimes

U.S. Attorney’s Office for the District of Nevada – Las Vegas Man Pleads Guilty To Opioids Overdose Death

Wisconsin NPR – Evers Signs Bill Giving Portion Of Potential Opioid Settlement To Local Governments

This Week’s Calendar

In the week ahead, there are no relevant events or hearings noticed at this time. In the event that there are any changes to the schedule for this week, we will make additional information available.

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