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NOPAIN Act Gains Foothold

ASCA’s and Voices’ joint advocacy efforts pay off

BY STEVEN SELDE | MARCH 2020

In the last week of February, the House Bipartisan Opioid Task Force published its agenda for the year. This agenda includes several bills, including the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, H.R. 5172, that the task force recommends the House of Representatives act on. Although it is unclear if the House or Senate will consider a broader package of legislation to continue to combat the opioid epidemic, the task force’s attention to the NOPAIN Act looks promising.

The NOPAIN Act would require the US Department of Health & Human Services (HHS) secretary to consider separate reimbursement for drugs and devices that help curtail post-operative opioid use in both ASCs and hospital outpatient departments (HOPD). In addition, this legislation would require the Centers for Medicare & Medicaid Services (CMS) to provide a report to Congress detailing similar barriers that might exist in Medicare for therapeutic approaches to acute pain.

Voices for Non-Opioid Choices (Voices), a nonpartisan coalition dedicated to preventing opioid addiction before it starts by increasing patient access to non-opioid therapies and approaches to managing acute pain, supported the introduction of the NOPAIN Act and, in 2019, ASCA joined Voices in its support.

Like ASCA’s National Advocacy Day, Voices held a fly-in event on Capitol Hill last December to help build support for the bill among lawmakers.

Today, the advocacy efforts of ASCA and Voices have borne fruit.

Among other opioids controlling measures, in 2018, Congress passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, P.L. 115-271, which contained several proposals to combat the epidemic. A key provision of that act directs the HHS to review and adjust payments under the Medicare Hospital Outpatient Prospective Payment System and ASC Payment System to “avoid financial incentives to use opioids instead of non-opioid alternative treatments.” Also in 2018, ASCA supported a regulatory proposal put forth by CMS that would unpackage and pay separately for the cost of non-opioid pain management drugs that function as surgical supplies when they are furnished in the ASC. CMS finalized this policy in the final rule for calendar year 2019 payments to ASCs.

Opioids, according to the Centers for Disease Control and Prevention (CDC), are the main driver of drug overdose deaths and accounted for 47,600 deaths in 2017 alone. Additionally, the CDC estimates that the economic costs associated with prescription opioid misuse exceed $78 billion annually.

ASCs play an important role in innovating healthcare delivery, and ASCA uses its position as an industry leader to give its members tools to stay at the forefront of their practice areas and provide their community with the best possible care. Over the last few years, both the association and federal policy makers have paid attention to combatting the opioid epidemic.

A variety of ASCA annual conference sessions and webinars have focused on the epidemic, best practices related to opioids and the various options available to practitioners who want to reduce the use of opioid-based medications. On the federal level, ASCA supports a comprehensive, national response aimed at resolving the current crisis through a combination of addiction prevention, early intervention and treatment, disease management and recovery support.

For more information or questions, write Steven Selde, ASCA’s assistant director of government and legislative affairs; and visit ASCA's Opioids Resource Center.