Chairman of the Health Subcommittee on Ways and Means, Representative Peter Roskam (R-IL), introduced a series of bipartisan bills to address the rapidly-growing opioid crisis. Three bills spearheaded by Chairman Roskam include:
H.R. 5725 -- Benefit Evaluation of Safe Treatment (BEST) Act, introduced by Chairman Roskam, House Democratic Caucus Vice Chair Linda T. Sánchez (D-CA), Congressman John Shimkus (R-IL) and Congressman Raul Ruiz (D-CA).
This legislation directs the Department of Health and Human Services to review and submit to Congress a report on the extent to which our nation's Medicare Advantage plans offer benefits designed to treat or prevent substance use disorders. Ensuring access to alternative non-opioid treatments is the first step to addressing severe addiction and pain. This bill will help identify the extent to which these treatments are covered outside of traditional Medicare coverage and encourage Medicare Advantage plans to continue to explore coverage for these new alternatives.
H.R. 5716 -- Commit to Opioid Medical Prescriber Accountability and Safety for Seniors (COMPASS) Act, introduced by Chairman Roskam, Congressman John Larson (D-CT), Congresswoman Susan Brooks (R-IN) and Congressman Peter Welch (D-VT).
This bill will require the Center for Medicare and Medicaid Services (CMS) to, in consultation with stakeholders, establish a threshold, based on specialty and geographic area, for which a prescriber would be considered an outlier opioid prescriber. CMS would then notify prescribers identified as outliers of their status. This process would act as a flag to prescribers to encourage them to evaluate their prescribing practices and to address any erroneous practices.
HR 5675 -- would require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries, introduced by Chairman Roskam, Health Subcommittee Ranking Member Sander Levin (D-MI), Congressman Gus Bilirakis (R-FL) and Congressman Ben Luján (D-NM).
Patient review and restriction programs are a common tool used to address the opioid crisis. These programs, often called "lock-in," directly address the problem of doctor shopping and pharmacy hopping by locking in a patient to a single designated provider and/or pharmacy. While Medicare Part D plans already have the authority to run a lock-in program, this legislation would require Part D plans to create such a program. This ensures uniformity and that high risk beneficiaries will be identified and assisted.
"The opioid crisis is whipsawing our culture. It is vital that we come together to solve it and these bipartisan bills move us in the right direction. In seeking feedback from doctors, pharmacists, hospitals and families in our district, I have heard excellent solutions that encourage the use of alternative treatments, increase provider education and assist with detection of those who are at-risk. Addiction knows no color, gender or political affiliation; we have millions of Americans suffering in pain who have fallen into a cycle of addiction. These bills address some of the most common causes of opioid dependency at their inception," said Chairman Roskam.