On February 16, ASAM along with 15 partner organizations representing healthcare professionals, patients and advocates dedicated to the prevention and treatment of substance use disorder (SUD), wrote to the Office of the Inspector General at the Department of Health and Human Services calling for the creation of a new safe harbor provision to the Federal Anti-kickback Statute (AKS) to protect the use of cash and cash-equivalent payments offered as part of contingency management (CM) in the treatment of SUD. CM is an evidence-based, psychosocial intervention that involves giving patients tangible monetary or non-monetary rewards (such as gift cards or vouchers) to reinforce positive behaviors such as treatment adherence (e.g., participation in therapy sessions, attendance at scheduled appointments, medication adherence) or reduced drug use/abstinence from drug use.

CM is an important tool for treating psychostimulant use disorder, for which there are no medications and few treatment options available. Recent data indicate that overdose deaths involving cocaine and psychostimulants, such as methamphetamine, have increased dramatically: provisional 12-month counts of overdose deaths involving psychostimulants increased by 34.8% from the 12-months ending in June 2019 compared to the 12-months ending in May 2020. Such a sharp increase underscores the need for broader access to psychostimulant use disorder treatment such as CM.

     Despite its demonstrated effectiveness in reducing substance use and promoting SUD treatment retention, CM is rarely available to patients, due in part to federal policy limiting the type and allowable cash value of incentives that can be used. Establishing a safe harbor for CM, with guardrails in place to ensure its appropriate use, would allow for the implementation of an established, effective treatment modality for SUD at a time when access to more effective treatment options is desperately needed.

As always, ASAM encourages members to consult legal counsel for advice on complying with all federal and state laws.

Read the full statement here