HHS expands access to buprenorphine in new actions to fight opioid epidemic

HHS has announced various new actions aimed at prevention, treatment and intervention to combat the opioid epidemic in the United States, according to a press release from the agency.

According to the release, the actions build on the National Pain Strategy and the HHS Opioid Initiative, which are focused on reducing chronic pain, increasing naloxone use, improving prescribing and expanding access to medication for opioid abuse.

“The opioid epidemic is one of the most pressing public health issues in the United States," Secretary Sylvia M. Burwell said in the release. "More Americans now die from drug overdoses than car crashes, and these overdoses have hit families from every walk of life and across our entire nation. At HHS, we are helping to lead the nationwide effort to address the opioid epidemic by taking a targeted approach focused on prevention, treatment, and intervention. These actions build on this approach. However, if we truly want to turn the tide on this epidemic, Congress should approve the president’s $1.1 billion budget request for this work.”

Sylvia M. Burwell

The agency's actions including expanding access to medication-assisted treatment (MAT), citing a final rule from the Substance Abuse and Mental Health Services Administration that allows providers to increase buprenorphine prescribing from 100 to 275 patients. Providers will need a waiver, which is available to those who have "additional credentialing in addiction medicine or addiction psychiatry from a specialty medical board and/or professional society, or practice in a qualified setting as described in the rule."

HHS also announced a proposal from CMS that would eliminate the pain management questions from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which are tied to Medicare payments for hospitals.

In addition, Indian Health Service clinicians will now be required to check state Prescription Drug Monitoring Program databases prior to prescribing opioids, which will help "improve appropriate pain management care, identify patients who may have an opioid misuse problem, and prevent diversion of drugs."

Finally, HHS announced the launch of more than a dozen new studies on pain treatment and opioid misuse and a call for feedback in order to improve prescriber training programs and education.

The AMA commended the announcement in a press release.

"The AMA applauds the critical steps announced today by Secretary Burwell to attack the opioid epidemic that is ravaging communities of all shapes and sizes across our country," Andrew W. Gurman, MD, AMA President, said in the release. "Medication-assisted treatment is proven effective, but for too long, too many patients have lacked access to this treatment. Today's final rule is an important step that nearly triples the number of patients [that] practitioners may treat with a waiver, but more must be done to leverage trained physicians to close the treatment gap."

He continued: "Treating pain is a priority for physicians, and we know that there are many ways to do so. Judging health care facilities on the subjective measure of how well pain is treated is an overly simplistic approach to measuring clinical effectiveness, and the AMA appreciates this proposal to sever the direct link between payment and pain management."