Negotiators for the House and Senate struck an agreement earlier this week on wide-ranging legislation to combat the opioid epidemic. H.R. 6, the SUPPORT for Patients and Communities Act, spans 660 pages and addresses battling the opioid crisis through new research, treatment and family resources. This comes on the heels of the Senate passing bipartisan opioid legislation in an overwhelming 99-1 vote last week. The House version likewise received overwhelming support, passing by a vote of 396-14 this past June.|
One particular omission in the final package was a provision related to end-stage renal disease (ESRD) financing measures included in the House-passed version of the opioids. NAHU had been closely monitoring the legislation, as it called for extending the amount of time that employer-sponsored plans must cover treatments of kidney disease for ESRD by three months before Medicare becomes the primary payer, which could have added an additional $46,000 per patient to employer costs. As a result, costs would shift to employers and potentially to patients who may face balance billing for these treatments. In response to the Senate’s passage of the legislation, NAHU joined the National Coalition on Benefits in sending a letter last week to legislators urging them to oppose the House-passed ESRD provision. The ESRD financing measure was eventually removed in deliberations between the House and Senate negotiators, thanks in part to NAHU and the National Coalition on Benefits advocacy efforts.
Moreover, the final opioids package is a culmination of work from multiple committees in the House and Senate. It includes such provisions as allowing hospitals to receive Medicaid payments when they take in more patients who have a mental illness or addiction (hospitals were only allowed to take in 16 previously) and allowing patients to stay for up to 30 days, as opposed to the current 15 day limit. However, another measure not included in the final package involved letting the Medicare program pay more for opioid alternatives that treat post-surgical pain. Additionally, negotiators left out a controversial House proposal that would have made it easier for doctors to share a patient’s substance abuse records. Republican leadership is planning to get the legislation to President Trump's desk before the midterm elections in November.