U.S. Sens. Pat Toomey and Joe Manchin and U.S. Reps. Harley Rouda and Markwayne Mullin are working together to provide greater assistance to individuals who have struggled with opioid misuse and abuse.
The Improving Medicaid Programs’ Response to Overdose Victims and Enhancing Addiction Care Act would require state Medicaid programs to use jointly funded drug utilization review programs to increase access to treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. The legislation would close an information gap that keeps prescribers uninformed about a patient who overdoses.
In 2018, Congress passed the SUPPORT for Patients and Communities Act resulting in Medicare Part D plan sponsors being notified of individuals with a history of opioid-related overdose — no notification or case management was previously required solely based on previous non-fatal overdose occurrence, despite studies linking previous non-fatal overdoses to subsequent fatal overdoses.
“No corner of Pennsylvania has been spared from the opioid epidemic,” Toomey said. “Physicians need to know if they’ve prescribed a lethal dose of opioids to a patient. The IMPROVE Addiction Care Act will ultimately promote better prescribing habits and help those battling addiction get the care they clearly need. I thank Sen. Manchin and Reps. Rouda and Mullin for working with me on this bipartisan bill, and I hope we are able to get this to the president’s desk before the end of the year.”
Specifically, the IMPROVE Addiction Care Act requires that states use drug utilization review programs to ensure that doctors are aware if their Medicaid-enrolled patient has suffered a previous nonfatal overdose and alert the prescriber when one of their patients suffers a fatal overdose; connect recent opioid overdose survivors who receive Medicaid benefits with treatment opportunities; and perform ongoing reviews and offer provider education.
A recent study of 3,606 Medicaid-enrolled adolescents (ages 13-22) who experienced an opioid-related overdose found that only one in 54 received medication-assisted treatment, and less than one in three received any treatment whatsoever. Medicaid beneficiaries often continue receiving legal opioid prescriptions even after suffering a nonfatal, opioid-related overdose. Boston University and Harvard Medical School found that 91 percent of patients who suffered an opioid-related overdose from 2000 to 2012 received another legal opioid prescription within a year.
