- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- Announcing the 2030 Census Disclosure Avoidance Research Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
COVID-19 Prompts ‘Lifesaving’ Policy Change for Opioid Addiction
Medscape, March 20, 2020
In the face of the US COVID-19 pandemic, the US Substance Abuse and Mental Health Services Administration (SAMHSA) has announced policy changes to allow some patients in opioid treatment programs (OTP) to take home their medication.
According to the agency, states may request “blanket exceptions” for all stable patients in an OTP to receive a 28-day supply of take-home doses of medications such as methadone and buprenorphine, which are used to treat opioid use disorder (OUD).
States may request up to 14 days of take-home medication for patients who are less stable but who can, in the judgement of OTP clinicians, safely handle this level of take-home medication.
“SAMHSA recognizes the evolving issues surrounding COVID-19 and the emerging needs OTPs continue to face,” the agency writes in its updated guidance. “SAMHSA affirms its commitment to supporting OTPs in any way possible during this time. As such, we are expanding our previous guidance to provide increased flexibility,” the agency said.
A “Lifesaving” Decision
Commenting on the SAMHSA policy change, Richard Saitz, MD, professor and chair of the department of community health sciences, Boston University School of Public Health, Massachusetts, said, the policy “is not only a good idea, it is critical and lifesaving.”
“This approach had to be done now. With the reduction in face-to-face visits, patients with opioid use disorder need a way to access treatment. If they cannot get opioid agonists, they would withdraw and return to illicit opioid use and high overdose risk and it would be cruel,” said Saitz. “It is possible that there will be some diversion and some risk of overdose or misuse, but even for less stable patients the benefit likely far outweighs the risk,” he told Medscape Medical News.
Saitz believes policy changes like this should have been made before a crisis. “Honestly, this is perhaps a silver lining of the crisis” and could lead to permanent change in how OUD is treated in the US, he said. “Just like we are learning what can be done without a medical in-person visit, we will learn that it is perfectly fine to treat patients with addiction more like we treat patients with other chronic diseases who take medication that has risks and benefits,” Saitz said.
Earlier this week, the Drug Enforcement Administration (DEA) also announced relaxed dispensing restrictions for registered narcotic treatment programs in cases when a patient is quarantined because of coronavirus.
Typically, only licensed practitioners can dispense or administer OUD medications to patients, but during the COVID-19 crisis, treatment program staff members, law enforcement officers, and national guard personnel will be allowed to deliver OUD medications to an approved “lockbox” at the patient’s doorstep. The change applies only while the coronavirus public health emergency lasts. This is also an excellent idea,” Saitz said.
ASAM Also Responds
In addition, the American Society of Addiction Medicine (ASAM) released a focused update to its National Practice Guideline for the Treatment of Opioid Use Disorder (NPG). The update is “especially critical in the context of the ongoing COVID-19 emergency, which threatens to curtail patient access to evidence-based treatment,” the organization said in a news release.
The new document updates the 2015 NPG. It includes 13 new recommendations and major revisions to 35 existing recommendations.
One new recommendation states that comprehensive assessment of a patient is critical for treatment planning, but completing all assessments should not delay or preclude initiating pharmacotherapy for OUD. Another new recommendation states that there is no recommended time limit for pharmacotherapy.
ASAM continues to recommend that patients’ psychosocial needs be assessed and psychosocial treatment offered. However, if patients can’t access psychosocial treatment because they are in isolation or have other risk factors that preclude external interactions, clinicians should not delay initiation of medication for the treatment of addiction.
Expanding the use of telemedicine might also be appropriate for many patients, ASAM announced. They note that the NPG is the first to address in a single document all medications currently approved by the US Food and Drug Administration (FDA) to treat OUD and opioid withdrawal, including all available buprenorphine formulations.
“All of the updated recommendations are designed to both improve the quality and consistency of care and reduce barriers to access to care for Americans living with OUD. The updated recommendations aim to support initiation of buprenorphine treatment in the emergency department and other urgent care settings,” the society said in the release.
“In addition, [the recommendations] provide greater flexibility on dosing during the initiation of buprenorphine treatment and for initiation of buprenorphine at home (which is also an important change in the midst of the COVID-19 crisis).”
The full document is available online.
Use of Telemedicine While Prescribing Medication Assisted Treatment
The Diversion Department of the US Department of Justice has reminded providers that the Ryan Haight Act of 2008 provides an exemption for most waivered providers prescribing Medication Assisted Treatment (MAT) to practice telemedicine while treating patients with Opioid Use Disorder (OUD). Please be sure to read the information here to learn more.
Managing Stress, Fear, and Anxiety Related to C0VID-19
As C0VID-19 affects numerous facets of our society, it impacts individuals and their mental health in very different ways. We are all feeling uncertainty and anxiety about what could happen with this pandemic, and those feelings are very normal to experience. If you have a mental health disorder, you may be consumed with constant worry and fear or your depression symptoms may be heightened due to social distancing. The Centers for Disease Control and Prevention (CDC) has created a webpage with healthy coping skills, information for parents on how to ease the anxiety in children, and many other resources that can be helpful during this time.
Colorectal Cancer Facts & Figures, 2020-2022
Colorectal cancer is the third most commonly diagnosed cancer, the third leading cause of cancer death in both men and women and the second overall when men and women are combined. The American Cancer Society’s Colorectal Cancer Facts & Figures, 2020-2022 report provides a comprehensive overview of colorectal cancer in the U.S., including statistics on colorectal cancer occurrence as well as information about risk factors, prevention, early detection and treatment.
Deadline Extended! Grants Aimed at Connecting Pennsylvania HIOs and Providers
The Pennsylvania Department of Human Services (DHS) has grants available to Pennsylvania Health Information Organizations (HIOs) to help connect hospitals and ambulatory practices (including health centers) to the PA eHealth Partnership Program’s Pennsylvania Patient & Provider Network (P3N). The P3N enables electronic health information exchange across the state through the connection of health care providers to an HIO, and the participation of the HIO in the P3N. The anticipated performance period for this grant runs through Sept. 30, 2020 but if you are interested in this program, it is crucial that you reach out to one of the PA certified HIOs as soon as possible. HIO’s must submit bids to DHS by March 31, 2020 for these grants. The original due date was March 24, 2020. Information about the PA certified HIOs can be found here.
Doximity Offers Free Postings in Response to COVID-19
Doximity, the medical professional social media platform with an effective but expensive recruitment feature, has pledged to help fill COVID-19-related MD/DO needs. Doximity will distribute these jobs or volunteer opportunities on its network free of charge. To take advantage of this offer you need to fill out the form. Doximity will distribute your job post to appropriate clinicians based on your location, specialty and any additional requirements. They will send applicants and responses directly to the contact information you provide on the form.
Pennsylvania Loan Repayment Recipients Impacted by Pandemic Won’t Be Penalized
If you or a staff member is currently a participant in the Pennsylvania Primary Care Loan Repayment Program, you will not be penalized for reduced hours or temporary loss of hours due to your facility’s response to COVID-19. The Pennsylvania Department of Health has confirmed that under provisions in Paragraph 27 (Default and Termination), sub-paragraph C, of the Standard General Terms and Conditions, grant agreements will not be terminated in the event that grantees cannot perform duties outlined in the grant agreements due to COVID-19 response and mitigation efforts. If loan repayment grantees are unable to perform the duties outlined in a grant agreement due to COVID-19, the grantees should contact the program administrator. Contact Judd Mellinger-Blouch, Director of the Pennsylvania Primary Care Career Center, with questions.
Blood Banks Facing Critical Shortage
Blood banks are asking healthy donors to turn out “in full force” as donations drop in the face of the spreading coronavirus. Because schools, churches and other businesses are closing, blood drives are being canceled. The American Red Cross on Tuesday tweeted that the nationwide organization is facing a severe shortage, indicating that 2,700 blood drives had been canceled as of Monday. That works out to 86,000 fewer donations. Anyone who is healthy is asked to consider giving.
Drug Distributors Seek to Settle Opioid Litigation for $19.2 Billion
The New York Times reported on March 13 that drug distributors McKesson, AmerisourceBergen and Cardinal Health are negotiating a deal to pay $19.2 billion over 18 years to states to settle opioid litigation. The companies would also agree to monitoring and oversight. In exchange, all plaintiffs, including cities and counties, would drop their lawsuits. Funds would go to state attorneys general, who would then be in control of distributing money to cities and counties. Read More.
Pennsylvania State Senate and House Vote to Change Rules in Response to COVID-19
On March 18, 2020, the Pennsylvania Senate approved a rule change that allows all members to vote outside the state Capitol in response to the coronavirus. The new rule allows members to participate and vote remotely using technology. The temporary rule will expire at the end of July or when Gov. Tom Wolf lifts his emergency declaration. The House also made temporary changes to its rules so members can submit their votes to party leaders and committee chairs, rather than be present in the Capitol. The party leaders and committee chairs must still be present if lawmakers want to consider legislation. House members also shortened the amount of time needed to move bills between the two chambers. The Senate did not follow but could later vote remotely to suspend the rules to move certain bills more quickly.