Should HHS Have an Action Plan for Improving the Treatment & Prevention of Opioid Addiction? (H.R. 5590)

What is H.R. 5590?

(Updated December 20, 2019)

This bill would require the Dept. of Health and Human Services (HHS) to develop an action plan for recommending changes to the Medicare and Medicaid programs to enhance: (1) the treatment and prevention of opioid addiction, and (2) the coverage and reimbursement of medication-assisted treatment (MAT) for opioid addiction. This action plan would be due by January 1, 2019.

The bill would also require HHS to convene a stakeholder meeting to solicit public comment on the action plan, issue a request for information within three months of the bill’s enactment, submit a report of its actions and findings to Congress by June 1, 2019.

Argument in favor

The magnitude of the opioid epidemic is tremendous, and expanding the role of Medicare and Medicaid as vehicles for delivering preventive and rehabilitative care is worth exploring.

Argument opposed

Medicare and Medicaid already cover some forms of detox, addiction medications, and inpatient treatment centers, so it’s not clear what recommendations HHS and the public may make.

Impact

Opioid epidemic; Medicare; Medicaid; and Health and Human Services.

Cost of H.R. 5590

The CBO estimates, based on historical spending patterns for similar activities, that implementing this bill would cost approximately $2 million over the 2019-2023 period.

Additional Info

In-Depth: Rep. Adam Kinzinger (R-IL) introduced this bill with Rep. Yvette D. Clarke (D-NY) to ensure the creation of policies to address the opioid abuse crisis at the coverage, reimbursement, treatment, and information provision level. Rep. Kinzinger said of the bill:

“For far too long, we have employed a ‘one size fits all’ method for treating pain and substance abuse disorder. We must have other options and in the 21st Century, we should be encouraging innovation and push the boundaries of our medical advances.  As we continue to face this devastating opioid epidemic, both Medicaid and Medicare are on the front lines and it’s critical that our policies are working towards the prevention of opioid abuse while still providing the care that patients need… I look forward to working towards putting an end to the opioid abuse crisis and creating a system that is flexible, adaptable, and focused on preventing and treating addiction.”

The Biotechnology Innovation Organization (BIO) supports this bill. BIO’s President and CEO, Jim Greenwood, said:

“As the largest payer of healthcare services in the country, the Centers for Medicare and Medicaid Services (CMS) has the ability to lead by example in developing policies that improve timely patient access to the most effective treatments for pain and addiction, as well as helping to stimulate research and investment in novel treatments to better meet patients’ needs. Specific and targeted updates to coverage and reimbursement policies impacting the Medicare and Medicaid programs will drive appropriate coverage of novel pain and addiction treatment across the United States. By directing CMS to develop an Opioid Action Plan, this Act would help accomplish this critical goal.”

This bill has six cosponsors, including two Democrats and four Republicans. There is a companion to this bill in the Senate, S. 2769, sponsored by Dean Heller (R-NV).

Of Note: The opioid epidemic impact is tremendous: in 2016, an average of over 115 across the country died of overdoses each day, adding up to 42,249 people dying from overdoses. That same year, HHS estimates that a total of 11.5 million people misused prescription opioids. In total, the epidemic carried a $504 billion economic cost.

In 2017, HHS declared the opioid epidemic a public health emergency and announced a 5-Point Strategy to Combat the Opioid Crisis with five specific strategies for HHS to execute against:

• Improving access to treatment and recovery services;

• Promoting use of overdose-reversing drugs;

• Strengthening our understanding of the epidemic through better public health surveillance;

• Providing support for cutting edge research on pain and addiction; and

• Advancing better practices for pain management

Media:

• Sponsoring Rep. Adam Kinzinger (R-IL) Press Release
  
• CBO Cost Estimate