The Senate voted on their opioids legislation on Tuesday, September 18 and passed it by a vote of 99 to 1 (Senator Mike Lee (R-UT)-no). Immediately they began negotiations on the Opioid Crisis Response Act of 2018, with their House counterparts. The hope is that they can get a quick deal and pass it before the election. There are differences between the two Houses. The House legislation included several dozen bills combined across committees and dealt with many of the same issues as the senate including better prescription drug monitoring and regulation through Medicare, Medicaid and other government bodies such as the CDC and FDA.
There are some differences. The House bill does not include an amendment to CAPTA to regulate how the new $60 million in CAPTA funding will be spent on plans of safe care. It also doesn’t include a version of the Senate Finance Committee bills (one of which is already included in the FY ’19 appropriations). The House bill does include a fix of extended Medicaid coverage to age 26 for youth that age out of foster care (Congressperson Karen Bass legislation). The House also addresses the IMD Medicaid restrictions which some view as an impediment to more Medicaid-funded drug treatment whereas the Senate does not.
Generally speaking the bills:
• Expand research and efforts on substance use through the National Institutes of Health (NIH)
• Enact tighter controls and monitoring of prescription drug and pain relief medications through Medicare and Medicaid
• Modify oversight through the Food and Drug Administration (FDA)
• Expand funding and drug treatment efforts through a grant program through the Substance Abuse and Mental Health Services Administration (SAMHSA)
• Direct HHS to provide best practices in housing substance abuse recovery programs
• Modify the IMD exclusion regarding pregnant and post-partum woman, clarifying the IMD exclusion in managed care plans
• Expand prescription drug recovery programs through the Department of Justice
The Senate is certain to remain in session pending a resolution of the Supreme Court vacancy but the House is not likely to remain much longer. The legislation also deals with some criminal penalties and Justice Department action which could also be a factor in any final deal.