Marilyn Singleton, MD, JD summarizes recent healthcare-related legislative activity on Capitol Hill.
On April 27, 2016, the House Energy and Commerce Committee, chaired by Rep. Fred Upton (R-MI), today approved 10 bills to help address the opioid and drug abuse crisis. These bills will advance to the full House of Representatives for consideration. The chairman recognized that “while there is no one solution, these bills represent good steps in addressing a problem that has grown rapidly.”
We all want to put an end to opiate overuse and overdoses, but some of these bills may create federal genies that cannot be put back in the bottle. When federal task forces start to define “best practices,” and offer only “evidence-based services,” we have to beware of stripping physician autonomy for those who practice good medicine with individualized treatment.
Bills advancing from the Health Subcommittee:
- H.R. 3250, the DXM Abuse Prevention Act of 2015 – Introduced July 28, 2015, authored by committee member Rep. Bill Johnson (R-OH) and Rep. Doris Matsui (D-CA), this legislation would prohibit the sale of a drug containing dextromethorphan (DXM) to an individual under 18, unless the individual has a prescription or is actively enrolled in the military and place restrictions on distribution of bulk DXM. DXM is commonly found in cough syrup.
Full text: https://www.govtrack.us/congress/bills/114/hr3250/text. - H.R. 3680, the Co-prescribing to Reduce Overdoses Act of 2015 – Introduced October 1, 2015, authored by committee member Rep. John Sarbanes (D-MD), this legislation would create a grant program for co- prescribing opioid reversal drugs for patients who are at a high risk of overdose.
Full text: https://www.govtrack.us/congress/bills/114/hr3680/text. - H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015 – Introduced October 6, 2015, authored by committee member Rep. Ben Lujan (D-NM), this legislation would reauthorize a residential treatment program that currently provides numerous services to aide pregnant women or postpartum women facing substance abuse.
https://www.govtrack.us/congress/bills/114/hr3691/text. - H. R. 4586, Lali’s Law – Introduced February 23, 2016, authored by Rep. Bob Dold (R-IL) and Rep. Katherine Clark (D-MA), this legislation would amend the Public Health Service Act to authorize grants to states for developing standing orders for naloxone prescriptions and educating health care professionals regarding the dispensing of opioid overdose reversal medication without person-specific prescriptions.
Full text: https://www.govtrack.us/congress/bills/114/hr4586/text. - H .R. 4599, the Reducing Unused Medications Act of 2016 – February 24, 2016, authored by Rep. Katherine Clark (D-MA) and Rep. Steve Stivers (R-OH), this legislation would amend the Controlled Substances Act (CSA) to clarify when a prescription for a drug listed on Schedule II of the CSA may be partially filled.
Full text: https://www.govtrack.us/congress/bills/114/hr4599/text. - H.R. 4641, to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes – Introduced February 26, 2016, authored by committee member Rep. Susan Brooks (R-IN), this legislation would establish an inter-agency task force to review, modify, and update best practices for pain management and how pain medication is prescribed.
Full text: https://www.govtrack.us/congress/bills/114/hr4641/text. - H.R. 4969, the John Thomas Decker Act – Introduced April 15, 2016, authored by Rep. Pat Meehan (R-PA), Rep. Ron Kind (D-WI), and Rep. Marc Veasey (D-TX), this legislation would amend the Public Health Service Act to direct HHS to study what information and resources are available to youth athletes and their families regarding the dangers of opioid use and abuse, non-opioid treatment options, and how to seek addiction treatment. HHS would then be required to report its findings and work with stakeholders to disseminate resources to students, parents, and those involved in treating a sports related injury.
Full text: https://www.govtrack.us/congress/bills/114/hr4969/text. - H.R. 4976, the Opioid Review Modernization Act – Introduced April 18, 2016, authored by Rep. Sean Maloney (D-NY) and committee member Rep. Leonard Lance (R-NJ), this legislation would require the FDA to work closely with expert advisory committees before making critical product approval and labeling decisions, and to make recommendations regarding education programs for prescribers of extended-release and long-acting opioids.
Full text: https://www.govtrack.us/congress/bills/114/hr4976/text. - H.R. 4978, the Nurturing and Supporting Healthy Babies Act –
Introduced April 18, 2016, authored by Rep. Evan Jenkins (R-WV) and Rep. Cheri Bustos (D-IL), this bipartisan legislation would require the Comptroller General of the United States to issue a report one year after enactment on Neonatal Abstinence Syndrome (NAS). Also passing with the bill was an amendment offered by Health Subcommittee Chairman Joseph Pitts (R-PA) and Rep. John Yarmuth (D-KY), which corrects an error in current law by exempting abuse-deterrent formulations (ADF) of prescription drugs from the definition of “line extension” when calculating Medicaid rebates, thus helping incentivize the development of ADF to combat opioid abuse. The cost of this change was offset by implementing a policy in the President’s FY2017 Budget that would prevent the public disclosure of predictive algorithms used to identify fraud in Medicare, Medicaid, and CHIP programs, a policy idea that Rep. Bilirakis (R-FL) first introduced last Congress.
Full text: https://www.govtrack.us/congress/bills/114/hr4978/text. - H.R. 4981, the Opioid Use Disorder Treatment Expansion and Modernization Act – Introduced April 18, 2016, authored by committee members Rep. Larry Bucshon, M.D. (R-IN) and Rep. Paul Tonko (D-NY), this legislation would amend the Controlled Substances Act to expand access to medication-assisted treatment, while ensuring that patients receive the full array of quality evidence-based services and minimizing the potential for drug diversion.
Full text: https://www.govtrack.us/congress/bills/114/hr4981/text. - H.R. 4982, Examining Opioid Treatment Infrastructure Act of 2016 – Introduced April 18, 2016, authored by Rep. Bill Foster (D-IL) and Rep. Frank Pallone, Jr. (D-NJ), this legislation would require the Comptroller General of the United States to issue a report to Congress on substance abuse treatment availability and infrastructure needs throughout the United States. This report shall include an evaluation of various substance abuse treatment settings including inpatient, outpatient, and detoxification programs. Also passing with the bill were two amendments, one offered by Rep. David McKinley (R-WV) and one offered by Rep. Markwayne Mullin (R-OK). Rep. McKinley’s amendment examines barriers to accessing real-time data on overdoses, and Rep. Mullin’s amendment studies access to treatment in the Indian health program.
Full text: https://www.govtrack.us/congress/bills/114/hr4982/text.
