and House negotiators settled on a legislative agreement to address the opioid
epidemic that should head to President Trump this month. The measure (H.R. 6) includes language to
modestly expand Medicaid inpatient coverage for addiction. The bill took months
of bipartisan work by eight House committees and five Senate committees. The
agreement includes measures to develop new nonaddictive painkillers and to
overhaul prescription drug monitoring programs. It would also reauthorize the
Office of National Drug Control Policy.
bill makes several changes to state Medicaid programs and adjusts Medicaid
requirements to address opioid and substance use disorders. It increases the
maximum number of patients that health care providers initially treat with
medication-assisted treatment. It also temporarily eliminates the enhanced
federal matching rate for Medicaid expenditures regarding specified medical
services provided by certain managed care organizations. Section 1004 of the bill would build on
current state Medicaid drug utilization review activities to monitor concurrent
prescribing of opioids and certain other drugs and monitor antipsychotic
prescribing for children.
revised final version of the bill adjusts the
definition of a religious group that is exempt from requirements of the Affordable
Care Act. If an individual is a member of a group that relies solely on a
religious method of healing they would be exempt from the requirement to have
health insurance. The revised version also makes $31 million available from the
Medicaid Improvement Fund, which was established to improve program management
and evaluate demonstration projects.