In the News: What Opioid Bill Could Mean for Clinicians, EHRs, PDMPs

Tuesday, September 25, 2018

Last week, the U.S. Senate passed its ambitious Opioid Crisis Response Act of 2018 (S.2680) by a vote of 99 to 1.

The bill differs substantially from the House-passed Overdose Prevention and Patient Safety Act (H.R. 6082), so the two pieces of legislation will need to be reconciled before a compromise version can be enacted into law. Nonetheless, many advocates are optimistic about some of the provisions the bill puts forward. These include:

  • Requiring e-prescribing of controlled substances within Medicare Part D
  • Increasing use of electronic prior authorization within Medicare Part D
  • Incentivizing use of electronic health records (EHRs) for behavioral health providers to help improve documentation and information exchange
  • Expanding telehealth services for substance abuse disorders

One key element of the legislation on which there is not yet consensus: privacy and disclosure. The House OPPS Act includes a provision that would eliminate existing regulations preventing physicians and care teams from recording a patient’s addiction-related medical history. The Senate bill maintains the current, decades-old practice of isolating addiction history from the rest of a patient’s HIPAA-protected medical history. Some care team members feel this practice creates a safety risk, leaving out potentially critical information they may need about the patient they are treating. Those in favor of the legacy regulations argue that protecting patients’ privacy is paramount.

The House bill would bring addiction history under the standard privacy protections of HIPAA. A coalition of organizations have urged the Senate to adopt this element of the House OPPS Act into its bill.  

Under the Senate bill, Prescription Drug Monitoring Programs (PDMPs) would be allowed to share data with state public health agencies and licensing boards, as well as giving state Medicaid access to PDMP data. The bill also reauthorizes a Department of Health and Human Services grant to fund PDMPs.

While it remains to be seen what the final opioid and overdose-prevention act will look like, many experts seem to think that Congress will reconcile the Senate and House versions of the bill quickly – maybe as early as next week – in order to put in place legislation addressing the oft-discussed opioid crisis.

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