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The SUPPORT for Patients and Communities Act (H.R. 6)

H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, is a bipartisan bill aimed at addressing the nation’s opioid overdose epidemic. The landmark legislation includes critical provisions to TEACH addiction medicine by increasing and strengthening our workforce, STANDARDIZE the delivery of addiction medicine and expand access to high-quality, evidence-based care, and COVER addiction medicine in a way that facilitates the delivery of coordinated and comprehensive treatment.

This latest effort to combat the opioid crisis follows the passage of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act last Congress.

ASAM applauds Congress for passing this critical and sweeping legislation. It is an important step in ensuring individuals with substance use disorder are able to get the help they need.


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  • Encourages increased training on addiction & pain in medical school/residency programs by authorizing $4M in grants for each of FY 2019-2023 to support curriculum development
  • New DATA 2000 waiver pathway for recent medical school graduates who have successfully completed curriculum covering DATA 2000 waiver training elements
  • Loan repayment program for SUD treatment providers practicing in high-need areas (up to $250,000); authorizes $25M for each of FY 2019-2023
  • Physicians board-certified in addiction medicine or addiction psychiatry or qualifying practitioners practicing in a qualified practice setting can immediately treat up to 100 patients with buprenorphine (in lieu of 30)
  • Permanent buprenorphine prescribing authority for NPs and PAs
  • Added qualifying clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwifes to list of practitioners eligible to prescribe buprenorphine until October 1, 2023
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  • Directs SAMHSA to provide information for entities applying for grants or cooperative agreements from SAMHSA to encourage the implementation & replication of evidence-based practices
  • Authorizes new grant resources ($10M for each of FY 2019 - 2023) for hospitals and other entities to develop protocols on discharging patients who have presented with an opioid overdose. Protocols would address the provision of an overdose reversal medication, such as naloxone, upon discharge, connection with peer-support specialists, and the referral to treatment and other services that best fit the patient’s needs
  • Oct. 1, 2019 - Sept. 30, 2023: State Medicaid plan amendment option to cover inpatient/residential treatment in facilities with more than 16 beds
    • 30 days for 12 month period
    • Must cover certain ASAM Levels of Care
    • Must ensure eligible individuals receive evidence-based assessments
    • Eligible facilities must follow evidence-based practices and offer at least 2 forms of MAT onsite, including in the case of MAT for OUD, at least one antagonist and one partial agonist
    • On November 6, 2019, CMS issued a State Medicaid Director Letter Regarding Implementation of Section 5052 of the SUPPORT for Patients and Communities Act – State Plan Option under Section 1915(l) of the Social Security Act. 
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  • OUD outpatient treatment demo in Medicare
    • Effective January 2021    
    • Emphasis on care coordination & bio-psychological-social model of care    
    • Enhances reimbursement and focuses on accountability metrics        
  • Medicare coverage of OTPs beginning January 2020
    • OTPs previously not covered by Medicare
    • Bundled payments for holistic services and coverage of methadone
    • Fee schedule updated yearly
  • Medicaid Re-entry Act
    • Law currently prohibits payment, but not enrollment for those in criminal justice settings   
    • HR 6 requires HHS to convene stakeholders to develop best practices for transitioning back into the community upon release    
  • October 2020 – September 30, 2025: Required coverage of OUD treatment medication in Medicaid, subject to some allowable exceptions.
  • Telehealth/telemedicine
    • Requires CMS to issue guidance to state Medicaid programs about the federal options for reimbursement of services delivered via telehealth
    • Waives requirement for beneficiary to be located in a county outside of a Metropolitan Statistical Area (MSA) or in a rural Health Professional Shortage Area (HPSA) located in a rural census tract beginning July 2019
    • Directs the Attorney General, with the Secretary of Health and Human Services, to issue final regulations by October 2019 to provide further guidance about the special registration process
  • Added testing of incentive payments for behavioral health providers that use certified-electronic health records as a priority for HHS
  • Requires the use of e-prescribing for schedule II-V controlled substances covered under a Medicare Part D prescription drug plan, or a Medicare advantage prescription drug plan starting January 2021
  • Controlled Substances Act has been changed to allow implantable or injectable medications which are controlled substances and are for the purposes of maintenance or detoxification treatment, to be delivered via specialty pharmacies