Obama Sets Task Force to Ensure Access to Addiction Tx

President warns about possible mandatory provider training

The Mental Health and Substance Use Disorder Parity Task Force will work to ensure access to coverage for behavioral health issues, Obama said here at the National Rx Drug Abuse and Heroin Summit.

The task force builds on the approach of the Mental Health Parity and Addiction Equity Act of 2008 in requiring that health insurance policies cover mental health and substance abuse treatment on par with treatment for physical illness; the group also will help enforce parity provisions included in the Affordable Care Act. The task force will identify best practices for compliance with parity laws and problem areas, in particular challenges accessing substance use disorder treatment.

“When it comes to how we oversee the parity provision in the [Affordable Care Act] we’ve got to let the insurance carriers know that we’re serious,” he said.

The group comprises directors from seven government agencies, including the departments of Treasury, Defense, Justice, Labor, Health and Human Services (HHS), and Veterans Affairs, as well as the Office of Personnel Management and the Office of National Drug Control Policy, according to a press release issued by the White House.

The director of the Domestic Policy Council will chair the group, and HHS will be responsible for funding and administrative support. The task force will release a report of its findings to the President on or before Oct. 31, 2016.

At the summit, the President also pressured Congress to approve his $1.1 billion funding request to address the crisis.

“For all the good work that Congress is doing, it’s not enough just to provide the architecture and the structure for more treatment; there has to be actual funding for the treatment,” he said.

The President also applauded the 60 medical schools who have pledged to require their students to receive training in prescriber education in order to graduate. He warned about possibly making some provider training mandatory.

“I think the medical community worries about their independence and over-regulation,” Obama said. “We have been getting some good volunteer efforts going … If in fact the training is not sufficient we may have to take a look at the possibility of mandatory training.”

Also on Tuesday, the Centers for Medicare and Medicaid Services (CMS) issued a final rule to bolster access to mental health and substance abuse disorders for low-income Americans enrolled in Medicaid and CHIP, to reflect the offerings of private insurance plans.

“Today’s rule eliminates a barrier to coverage for the millions of Americans who for too long faced a system that treated behavioral health as an unequal priority,” said HHS Secretary Sylvia Burwell in a press release. She stressed that the new rule would increase access to evidence-based treatments for substance use disorders specifically, and allow states the option of offering services through managed care models outside of Medicaid.

The new rule also requires states to explain any denial of reimbursement or payment for services associated with mental health and substance use disorder benefits.

A White House press release also highlighted additional efforts from HHS, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of National Drug Control Policy (ONDCP), which include:

An HHS proposal to increase the cap on the number of patients to whom qualified clinicians can prescribe buprenorphrine from 100 to 200
$94 million in new funding from HHS to allow 271 community health centers in high-need areas to expand their substance use disorder services
New guidance from HHS for programs focused on using federal funds to grow syringe service programs
$11 million in grants from SAMHSA to help 11 states increase access to medication assisted treatment and training in high-need areas to qualify more physicians to prescribe buprenorprine

Expansion of the ONDCP’s High Intensity Drug Trafficking Area program to two additional states — Ohio and Michigan

Patrice Harris, MD, a psychiatrist, chair-elect of the American Medical Association (AMA), and chair of the AMA Task Force to Reduce Opioid Abuse, also spoke at the summit, noting that physicians must take responsibility for ending the epidemic.

She spoke of the recent drop in opioid prescriptions, 2.9% nationally from 2013 to 2014 and 6.8% from 2014 to 2015, according to a press release. However, she stressed the need to focus not on shrinking these numbers but on providing appropriate care.

“Patients with pain deserve our care and compassion – not our judgment. The key is to ensure that we are providing the most effective treatment possible, which may or may not include opioids,” Harris said.