October 26, 2018—As the second session of the 115th Congress nears the election, members of the House of Representatives and the Senate recently agreed on a comprehensive legislative package to help end the scourge of opioid addiction. The opioid issue, which federal and local legislatures across the country have been grappling with for several years, will soon see more federal dollars being focused on ways to help alleviate the destructive force associated with the addiction.
In the legislation are several provisions that are of interest to the chiropractic profession. One in particular would require the federal Centers for Medicare and Medicaid Services (CMS) to review payments made through the Outpatient Prospective Payment System (OPPS) and payments to ambulatory surgery centers (ASCs) to ensure there are no financial incentives to use opioids instead of evidence-based non-opioid alternatives, such as chiropractic or other health care services. If CMS identifies that financial incentives are being used by a hospital or out-patient clinic to use opioids instead of evidence-based non-opioid alternatives, CMS is directed to make revisions to OPPS and ASC payments through rulemaking.
Another provision in the 660-page bill requires the U.S. Department of Health and Human Services (HHS), in consultation with relevant stakeholders (which could include chiropractors) to submit a report to Congress on how to improve reimbursement and coverage for multi-disciplinary, evidence based non-opioid chronic pain management. The report must also include options for improving treatment strategies and case management for various high-risk patient populations and options for improving and disseminating pain management education tools.
Yet another provision of the bill would update the scope of the Interagency Pain Research Coordinating Committee to identify risk factors for, and early warning signs of, substance use disorders, and summarize advances in pain care research supported or conducted by the federal government, including information on best practices for the utilization of non-pharmacologic treatments. This is another area where chiropractors could become involved.
As this article was posted, the president was expected to sign the opioids bill before the end of October. As with any bill of this size, there will be several rounds of rule-making distributed primarily through HHS to ensure the intent of the legislation is carried out. Be assured ACA will monitor all related activities to ensure the profession is “at the table” when alternatives to opioids are discussed and implemented.
For more information on how chiropractic’s non-drug approach to pain relief can help alleviate the opioid crisis, click here.
John Falardeau is the American Chiropractic Association’s senior vice president for public policy and advocacy.