President Signs SUPPORT for Patients and Communities Act into Law

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President Signs SUPPORT for Patients and Communities Act into Law

How this might affect ASCs

During a special signing event last week, President Donald Trump signed into law the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (H.R. 6). The president’s signature on October 25 comes three weeks after the US Senate passed the legislation 98 to 1, and about a year after he first declared the opioid epidemic a national emergency.

In a press release from the US House of Representatives Energy and Commerce Committee, Chairman Greg Walden (R-OR) and Health Subcommittee Chairman Mike Burgess, MD (R-TX) stated that “while there is still much work to be done, this historic effort will undoubtedly save lives and put families and communities across our country on the road to recovery.”

A key provision in the act that affects ASCs relates to Medicare, Medicaid, information technology, telehealth, community services, education and research. This provision directs the US Department of Health and Human Services (HHS) to review and adjust payments under the Medicare Hospital Outpatient Prospective Payment System 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.

Other Medicare provisions in the bill that might impact ASCs:

  • Medicare opioid safety – HHS will establish an action plan, with subsequent reports to Congress, on recommendations for changes under Medicare and Medicaid to prevent opioids addictions and enhance access to medication-assisted treatment.
  • Electronic prior authorization for covered Medicare Part D drugs – HHS will establish a standard and secure electronic prior authorization system for prescribing covered Medicare Part D drugs no later than January 1, 2021.
  • Medicare Payment Advisory Commission (MedPAC) report – MedPAC will submit a report to Congress on: (1) how Medicare pays for pain management treatments in inpatient and outpatient hospital settings; (2) current incentives for prescribing opioid and non-opioid treatments under Medicare inpatient and outpatient prospective payment systems; and (3) how opioid use data is tracked and monitored through Medicare claims data.
  • 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.
  • Review of quality measures related to opioids – Within six months, HHS will to convene a Technical Expert Panel (TEP) to review quality measures related to opioids and opioid use disorders. The TEP will: (1) review existing measures; (2) identify gaps in quality measurement and prioritize development in gap areas; and (3) make recommendations regarding revisions of existing measures, development of new measures and recommendations for inclusion of such measures in value-based payment programs.
  • Reducing opioid use in surgical settings – 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 will post online all opioid prescribing guidance published after January 1, 2016, applicable to Medicare beneficiaries.

For more information on this legislation and other federal activity, write Jeff Evans.