ACAP Response to Senate Finance Committee RFI on Addressing the Opioid Epidemic

February 16, 2018

The Honorable Orrin Hatch                               The Honorable Ron Wyden
Chairman, Senate Finance Committee             Ranking Member, Senate Finance Committee
219 Dirksen Senate Office Building                   219 Dirksen Senate Office Building
Washington, DC 20510                                       Washington, DC 20510

Sent Electronically

Chairman Hatch and Senator Wyden:

On behalf of the Association for Community Affiliated Plans (ACAP) and our 61 member plans serving more than 20 million Americans in Medicaid, Medicare, CHIP and the health insurance exchanges, we are honored to offer our perspective and legislative recommendations to address America’s opioid and substance abuse epidemic.

In summary, ACAP:

  • Urges Congress to require reporting of a core set of measure for adults across all Medicaid delivery systems, which include measures related to SUD and OUD, by enacting the Medicaid and CHIP Quality Improvement Act (H.R.2843/S.1317); and
  • Encourages collaborative development of additional valid, reliable, and actionable measures of appropriate opioid prescribing, aligned across various programs.
  • Urges Congress to reduce “churn” that undermines the effectiveness of substance abuse treatment regiments and patient monitoring by enacting the Stabilize Medicaid and CHIP Coverage Act (H.R. 2628/S. 1227) to provide 12-month continuous eligibility for Medicaid beneficiaries.
  • Encourages Congress to enact S. 1850, the Protecting Jessica Grubb’s Legacy Act, and H.R. 3545, the Overdose Prevention and Patient Safety Act, both bipartisan bills that would align rules governing SUD treatment records with HIPAA
  • Recommends that public and private-sector leaders commit to working together to encourage prescribing of Medication-Assisted Therapy (MAT), while developing new safeguards to promote appropriate, evidence-based treatment, particularly with respect to providers who only accept payment in cash for their services.
  • Urges Congress to add MAT to the list of essential health benefits requiring coverage by QHPs.
  • Requests permission be granted for Medicaid health plans to access state PDMP data for their membership in order to identify a larger proportion of patients in need of prescription drug abuse intervention and to initiate timely, effective outreach.
  • Recommends requiring all prescribing providers, including emergency rooms, to fully utilize PDMPs.
  • Recommends that when beneficiaries enrolled in a pharmacy or prescriber lock-in program change health plans, State Medicaid agencies should inform the new health plan on a timely basis of the individual’s lock-in status.