Standardize the Delivery of Individualized Addiction Treatment

Standardize adm care

New policies and culture change are needed to direct patients to treatment options that can reduce overdose deaths and at support patients in remission and recovery. Wide variability in addiction medicine training and treatment have prevented far too many Americans from accessing evidence-based care for this chronic, treatable disease.

Recent Advocacy Successes:

  • In 2018,  ASAM advocated for, and Congress enacted, legislation to allow state Medicaid programs to cover addiction treatment in certain Institutions for Mental Diseases (IMD) for fiscal years 2019-2023.
  • In 2018, ASAM successfully advocated for Congress to direct the Substance Abuse and Mental Health Services Administration (SAMHSA) to encourage potential grantees to implement and replicate evidence-based practices.
  • In 2020, ASAM, as a member of the Partnership to Amend Part 2, helped secure enactment of legislation that will substantially change 42 CFR Part 2 to allow the contents of substance use disorder patient records to be used or disclosed by a covered entity, business associate, or Part 2 program for treatment, payment or healthcare operations as permitted by the Health Insurance Portability and Accountability Act (HIPAA), after prior written patient consent has been obtained. Any information so disclosed could then be redisclosed in accordance with the HIPAA regulations.  To learn more, click here.

Priorities Moving Forward

  • Federal legislation that incentivizes states to adopt standards for the licensure of addiction treatment programs that meet or exceed the nationally recognized guidelines contained in The ASAM Criteria® and insurers to use The ASAM Criteria as their medical necessity criteria for SUD benefits.
  • Development of an ASAM policy guide for states that wish to transform the delivery of addiction treatment services through the use of The ASAM Criteria.
  • Federal legislation that eliminates the separate DEA waiver requirement for prescribing certain medications for addiction treatment, like buprenorphine, and establishes a requirement that all prescribers of controlled medications complete a specified amount of addiction training.
  • Legislative and regulatory changes to align 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for treatment, payment, and operations, while leaving in place Part 2 prohibitions on disclosure of records outside the healthcare system along with penalties for violation of such prohibitions.
  • Amendment of the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential  and inpatient settings that provide FDA-approved medications for addiction treatment and that can demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are evidence-based and aligned with nationally recognized addiction treatment and placement criteria such as The ASAM Criteria.
  • Legislative and regulatory changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of SUD.  The special registration exemption also should not limit the number of detained or incarcerated persons who can be treated with such medications by a qualified practitioner.