[Congressional Record Volume 164, Number 102 (Tuesday, June 19, 2018)]
[House]
[Pages H5247-H5249]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
OPIOID ADDICTION ACTION PLAN ACT
Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 5590) to require the Secretary of Health and Human Services
to provide for an action plan on recommendations for changes under
Medicare and Medicaid to prevent opioids addictions and enhance access
to medication-assisted treatment, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 5590
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Opioid Addiction Action Plan
Act''.
SEC. 2. ACTION PLAN ON RECOMMENDATIONS FOR CHANGES UNDER
MEDICARE AND MEDICAID TO PREVENT OPIOIDS
ADDICTIONS AND ENHANCE ACCESS TO MEDICATION-
ASSISTED TREATMENT.
(a) In General.--Not later than January 1, 2019, the
Secretary of Health and Human Services (in this section
referred to as the ``Secretary''), in collaboration with the
Pain Management Best Practices Inter-Agency Task Force
convened under section 101(b) of the Comprehensive Addiction
and Recovery Act of 2016 (Public Law 114-198), shall develop
an action plan that provides recommendations described in
subsection (b).
(b) Action Plan Components.--Recommendations described in
this subsection are, based on an examination by the Secretary
of potential obstacles to an effective response to the opioid
crisis, recommendations, as determined appropriate by the
Secretary, on the following:
(1) Recommendations on changes to the Medicare program
under title XVIII of the Social Security Act and the Medicaid
program under title XIX of such Act that would enhance
coverage and payment under such programs of all medication-
assisted treatment approved by the Food and Drug
Administration for the treatment of opioid addiction and
other therapies that manage chronic and acute pain and treat
and minimize risk of opioid addiction, including
recommendations on changes to the Medicare prospective
payment system for hospital inpatient department services
under section 1886(d) of
[[Page H5248]]
such Act (42 U.S.C. 1395ww(d)) and the Medicare prospective
payment system for hospital outpatient department services
under section 1833(t) of such Act (42 U.S.C. 1395l(t)) that
would allow for separate payment for such therapies, if
medically appropriate and if necessary to encourage
development and adoption of such therapies.
(2) Recommendations for payment and service delivery models
to be tested by the Center for Medicare and Medicaid
Innovation and other federally authorized demonstration
projects, including value-based models, that may encourage
the use of appropriate medication-assisted treatment approved
by the Food and Drug Administration for the treatment of
opioid addiction and other therapies that manage chronic and
acute pain and treat and minimize risk of opioid addiction.
(3) Recommendations for data collection that could
facilitate research and policy making regarding prevention of
opioid addiction and coverage and payment under the Medicare
and Medicaid programs of appropriate opioid addiction
treatments.
(4) Recommendations for policies under the Medicare program
and under the Medicaid program that can expand access for
rural, or medically underserved communities to the full range
of medication-assisted treatment approved by the Food and
Drug Administration for the treatment of opioid addiction and
other therapies that manage chronic and acute pain and
treatment and minimize risk of opioid addiction.
(5) Recommendations on changes to the Medicare program and
the Medicaid program to address coverage or payment barriers
to patient access to medical devices that are non-opioid
based treatments approved by the Food and Drug Administration
for the management of acute pain and chronic pain, for
monitoring substance use withdrawal and preventing overdoses
of controlled substances, and for treating substance use
disorder.
(c) Stakeholder Meetings.--
(1) In general.--Beginning not later than 3 months after
the date of the enactment of this Act, the Secretary shall
convene a public stakeholder meeting to solicit public
comment on the components of the action plan recommendations
described in subsection (b).
(2) Participants.--Participants of meetings described in
paragraph (1) shall include representatives from the Food and
Drug Administration and National Institutes of Health,
biopharmaceutical industry members, medical researchers,
health care providers, the medical device industry, the
Medicare program, the Medicaid program, and patient
advocates.
(d) Request for Information.--Not later than 3 months after
the date of the enactment of this section, the Secretary
shall issue a request for information seeking public feedback
regarding ways in which the Centers for Medicare & Medicaid
Services can help address the opioid crisis through the
development of and application of the action plan.
(e) Report to Congress.--Not later than June 1, 2019, the
Secretary shall submit to Congress, and make public, a report
that includes--
(1) a summary of recommendations that have emerged under
the action plan;
(2) the Secretary's planned next steps with respect to the
action plan; and
(3) an evaluation of price trends for drugs used to reverse
opioid overdoses (such as naloxone), including
recommendations on ways to lower such prices for consumers.
(f) Definition of Medication-Assisted Treatment.--In this
section, the term ``medication-assisted treatment'' includes
opioid treatment programs, behavioral therapy, and
medications to treat substance abuse disorder.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Kentucky (Mr. Guthrie) and the gentleman from Massachusetts (Mr.
Kennedy) each will control 20 minutes.
The Chair recognizes the gentleman from Kentucky.
General Leave
Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
insert extraneous materials in the Record on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Kentucky?
There was no objection.
{time} 1530
Mr. GUTHRIE. Mr. Speaker, I yield myself as much time as I may
consume.
Mr. Speaker, I want to commend Representative Kinzinger,
Representative Clarke, Representative LaHood, and Representative Davis
for their work on this important bipartisan bill.
H.R. 5590 requires the Department of Health and Human Services to
develop an opioid addiction plan to evaluate what HHS is doing across
the department to address the opioid crisis and how it can be improved.
This action plan will include an evaluation of coverage and
reimbursement rates for nonopioid pain treatments, the potential role
of medical devices in addressing this crisis, and the availability of
treatment for rural and medically underserved communities, among other
components.
In addition, Medicare and Medicaid are on the front lines of this
epidemic, and we need to be sure that they are not creating adverse
incentives that can harm beneficiaries with coverage and reimbursement
decisions.
The issues addressed in this bill will also provide an informative
review of how CMS can continue to fight this national crisis.
Mr. Speaker, I urge my colleagues to support and pass this bipartisan
bill, and I reserve the balance of my time.
House of Representatives,
Committee on Energy and Commerce,
Washington, DC, June 7, 2018.
Hon. Kevin Brady,
Chairman, Committee on Ways and Means,
Washington, DC.
Dear Chairman Brady: On May 9 and 17, 2018, the Committee
on Energy and Commerce ordered favorably reported over 50
bills to address the opioid epidemic facing communities
across our nation. Several of the bills were also referred to
the Committee on Ways and Means.
I ask that the Committee on Ways and Means not insist on
its referral of the following bills so that they may be
scheduled for consideration by the Majority Leader:
H.R. 1925, At-Risk Youth Medicaid Protection Act of 2017;
H.R. 3331, To amend title XI of the Social Security Act to
promote testing of incentive payments for behavioral health
providers for adoption and use of certified electronic health
record technology;
H.R. 3528, Every Prescription Conveyed Securely Act;
H.R. 4841, Standardizing Electronic Prior Authorization for
Safe Prescribing Act of 2018;
H.R. 5582, Abuse Deterrent Access Act of 2018;
H.R. 5590, Opioid Addiction Action Plan Act;
H.R. 5603, Access to Telehealth Services for Opioid Use
Disorder;
H.R. 5605, Advancing High Quality Treatment for Opioid Use
Disorders in Medicare Act;
H.R. 5675, To amend title XVIII of the Social Security Act
to require prescription drug plan sponsors under the Medicare
program to establish drug management programs for at-risk
beneficiaries;
H.R. 5684, Protecting Seniors from Opioid Abuse Act;
H.R. 5685, Medicare Opioid Safety Education Act;
H.R. 5686, Medicare Clear Health Options in Care for
Enrollees (CHOICE) Act;
H.R. 5715, Strengthening Partnerships to Prevent Opioid
Abuse Act;
H.R. 5716, Commit to Opioid Medical Prescriber
Accountability and Safety for Seniors (COMPASS) Act;
H.R. 5796, Responsible Education Achieves Care and Healthy
Outcomes for Users' Treatment (REACH OUT) Act of 2018;
H.R. 5798, Opioid Screening and Chronic Pain Management
Alternatives for Seniors Act;
H.R. 5804, Post-Surgical Injections as an Opioid
Alternative Act; and
H.R. 5809, Postoperative Opioid Prevention Act of 2018.
This concession in no way affects your jurisdiction over
the subject matter of these bills, and it will not serve as
precedent for future referrals. In addition, should a
conference on the bills be necessary, I would support your
request to have the Committee on Ways and Means on the
conference committee. Finally, I would be pleased to include
this letter and your response in the bill reports and the
Congressional Record.
Thank you for your consideration of my request and for the
extraordinary cooperation shown by you and your staff over
matters of shared jurisdiction. I look forward to further
opportunities to work with you this Congress.
Sincerely,
Greg Walden
Chairman.
____
House of Representatives,
Committee on Ways and Means,
Washington, DC, June 8, 2018.
Hon. Greg Walden,
Chairman, Committee on Ways and Means,
Washington, DC.
Dear Chairman Walden: Thank you for your letter concerning
several bills favorably reported out of the Committee on
Energy and Commerce to address the opioid epidemic and which
the Committee on Ways and Means was granted an additional
referral.
As a result of your having consulted with us on provisions
within these bills that fall within the Rule X jurisdiction
of the Committee on Ways and Means, I agree to waive formal
consideration of the following bills so that they may move
expeditiously to the floor:
H.R. 1925, At-Risk Youth Medicaid Protection Act of 2017;
H.R. 3331, To amend title XI of the Social Security Act to
promote testing of incentive payments for behavioral health
providers for adoption and use of certified electronic health
record technology;
H.R. 3528, Every Prescription Conveyed Securely Act;
H.R. 4841, Standardizing Electronic Prior Authorization for
Safe Prescribing Act of 2018;
H.R. 5582, Abuse Deterrent Access Act of 2018;
H.R. 5590, Opioid Addiction Action Plan Act;
[[Page H5249]]
H.R. 5603, Access to Telehealth Services for Opioid Use
Disorder;
H.R. 5605, Advancing High Quality Treatment for Opioid Use
Disorders in Medicare Act;
H.R. 5675, To amend title XVIII of the Social Security Act
to require prescription drug plan sponsors under the Medicare
program to establish drug management programs for at-risk
beneficiaries;
H.R. 5684, Protecting Seniors from Opioid Abuse Act;
H.R. 5685, Medicare Opioid Safety Education Act;
H.R. 5686, Medicare Clear Health Options in Care for
Enrollees (CHOICE) Act;
H.R. 5715, Strengthening Partnerships to Prevent Opioid
Abuse Act;
H.R. 5716, Commit to Opioid Medical Prescriber
Accountability and Safety for Seniors (COMPASS) Act;
H.R. 5796, Responsible Education Achieves Care and Healthy
Outcomes for Users' Treatment (REACH OUT) Act of 2018;
H.R. 5798, Opioid Screening and Chronic Pain Management
Alternatives for Seniors Act;
H.R. 5804, Post-Surgical Injections as an Opioid
Alternative Act; and
H.R. 5809, Postoperative Opioid Prevention Act of 2018.
The Committee on Ways and Means takes this action with the
mutual understanding that we do not waive any jurisdiction
over the subject matter contained in this or similar
legislation, and the Committee will be appropriately
consulted and involved as the bill or similar legislation
moves forward so that we may address any remaining issues
that fall within our jurisdiction. The Committee also
reserves the right to seek appointment of an appropriate
number of conferees to any House-Senate conference involving
this or similar legislation and requests your support for
such a request.
Finally, I would appreciate your commitment to include this
exchange of letters in the bill reports and the Congressional
Record.
Sincerely,
Kevin Brady,
Chairman.
Mr. KENNEDY. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 5590 sponsored by
Representatives Kinzinger and Clarke. I commend my colleagues for their
hard work on this legislation.
We know that there is more that the Department of Health and Human
Services needs to do to address the opioid crisis. We know that we need
to do more not only to bring down opioid prescribing, but to expand
access to medication-assisted treatment for opioid use disorders.
H.R. 5590 would direct the Secretary of HHS to examine potential
obstacles to an effective response to the opioid crisis and issue
recommendations for addressing them. It directs the Secretary to look
at barriers to both wider use of nonopioid alternatives to manage pain,
as well as therapies that treat opioid addiction.
Mr. Speaker, while this is an important bill, I want to underscore
that it is incremental.
I also want to reiterate my continuing concern that while Democrats
support working on a legislative package to address the opioid crisis,
as we have over the course of the day-to-day and over the course of the
past several weeks with our Republican colleagues, we must also assure
that we first do no harm.
The Trump administration and Republican efforts to dismantle the
Affordable Care Act would do serious harm to our healthcare system and
to individuals suffering from opioid use disorders specifically.
For instance, the Trump administration continues to undermine the
individual market by promoting junk insurance plans, such as short-
term, limited duration health plans.
These plans would allow insurers to once again exclude individuals
with preexisting conditions, such as opioid use disorder, and charge
individuals more based on their health status. It would make coverage
for individuals who need comprehensive health coverage, such as
individuals with opioid use disorders, less affordable and accessible.
Moreover, apparently Republicans are not done with their efforts to
repeal the ACA. Despite public backlash to repeal efforts last year and
despite statements today expressing concern about the opioid crisis,
news reports indicate that Republicans are once again planning to make
another effort to try to repeal the Affordable Care Act.
The opioids package cannot be considered in a vacuum. Ongoing efforts
to sabotage and repeal the ACA will not only reverse the gains that we
make from these efforts today, but will inflict lasting harm to our
healthcare system and our ability to fight the opioid crisis.
Mr. Speaker, I yield back the balance of my time.
Mr. GUTHRIE. Mr. Speaker, I yield back the balance of my time.
Ms. CLARKE of New York. Mr. Speaker, let me take this time to express
my appreciation to Chairman Walden and Ranking Member Pallone, for
their leadership in addressing the opioid epidemic in the U.S. House of
Representatives.
On April 24th of this year, I had the opportunity to work across the
aisle in introducing bipartisan legislation with my Energy and Commerce
colleague, Congressman Adam Kinzinger of Illinois.
We were joined by two additional colleagues as original co-sponsors,
who sit on the House Ways and Means Committee--Rep. Darrin LaHood, my
Republican colleague from Illinois and Rep. Danny K. Davis, my CBC
Colleague who hails from Illinois as well.
Our bill, The Opioid Addiction Action Plan of 2018, is a roadmap to
not only abating the opioid epidemic, but to engaging industry to be
innovative in the development of new pain management therapies.
There are many players and much is at stake.
According to the National Institutes of Drug Abuse, there are more
than 115 opioid related deaths per day.
The CDC estimates that the economic burden of prescription opioid
misuse is roughly $78.5 billion a year--and that's in the U.S. alone.
Since we know the enormity of this issue plaguing our country,
passing H.R. 5590 would require that the Centers for Medicare and
Medicaid Services (CMS) seeks stakeholder feedback as well as public
comment, before producing an Opioid Addiction Act Plan report to
Congress.
It is going to take all of us to tackle this national opioid
epidemic.
And Mr. Speaker, with the opioid crisis at epic levels, government
cannot do this alone.
That is why we are calling on all of our partners to aide in the
fight against opioid addiction in our communities--for both addiction
to prescription painkillers and addiction to synthetics, including
heroin and fentanyl.
Overdose deaths that were once perceived as largely a rural white
problem have now become widespread among black Americans in urban
communities who are dying from horrific rates of fentanyl overdoses.
While white Americans die at greater rates of overdose deaths,
overdose death rates have been steadily increasing among black
Americans since 2011--at the time that fentanyl and heroin, as well as
other synthetics began to climb.
One of the solutions to the ever-growing problem to the opioid crisis
in the black community is access to addiction care treatment.
Traditionally, African Americans have had unequal access to quality
health care in comparison to our white counterparts.
This legislation would also mandate improved data collection to
better understand the opioid crisis.
H.R. 5590 directs the CMS to develop an Opioid Addiction Action Plan
to address challenges for treatment of substance abuse disorders.
Additionally, this bill also identifies non-opioid pain management
options and make considerations for Medicare and Medicaid coverage and
reimbursement of medication-assisted treatment (MAT) for opioid use
disorders.
In addition to making sure our communities have access to medication-
assisted treatment, it is important that we help them in the event
someone is in the midst of an overdose.
Mr. Speaker, we cannot leave those behind who need us most.
We are our brother's and our sister's keepers.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Kentucky (Mr. Guthrie) that the House suspend the rules
and pass the bill, H.R. 5590, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
____________________