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Congress’ Extensive Opioid Legislation Becomes Law

On Wednesday, October 24, President Trump signed the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (H.R. 6) into law.

The bill signing occurred three weeks following Congress’ overwhelming approval of the measure, and nearly one year since the Trump Administration deemed America’s opioid crisis a federal public health emergency. House Energy and Commerce Committee Chairman Greg Walden (R-OR) and Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN), chief architects of the legislation, joined patient advocates and congressional and agency leaders at the White House ceremony.

H.R. 6, which represents a bipartisan, bicameral agreement, largely modifies Medicare and Medicaid policies to better prevent and combat opioid abuse. Other elements seek to expand comprehensive substance use disorder treatment supports, particularly in local communities, as well as address associated health workforce shortages.

While House and Senate leadership embraced pre-conference discussions to allow for the swift negotiation of a final package, differing opinions on several provisions still proved contentious.

By approving a partial repeal of the decades-old Institutions for Mental Diseases (IMD) exclusion, conferees ultimately permitted states for five years to request Medicaid payment for 30-day inpatient addiction treatment at facilities with more than 16 beds.

Additionally, following considerable debate and stakeholder input, conferees opted not to loosen certain information-sharing amongst providers by rejecting the alignment of privacy provisions governing patient substance use disorder records with 42 CFR, Part 2 laws.

© Copyright 2019 Squire Patton Boggs (US) LLP


About this Author

John E. Wyand, Squire Patton Boggs, Healthcare Lawyer, UK

John Wyand, a Partner in our Healthcare policy practice group in Washington DC, focuses on advising healthcare and life sciences companies and providers on legal, policy and regulatory issues. Additionally, he regularly assists hospitals and physician groups in developing strategies for hospital/physician alignment, mergers and acquisitions, and fraud and abuse compliance.

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Victoria Cram Attorney Squire Patton Boggs

Victoria Cram is the co-chair of the firm’s Transportation, Infrastructure & Local Government Public Policy Practice. She brings more than 25 years of federal advocacy experience representing local governments, other public sector entities and nonprofit organizations in Washington DC with a substantive background in urban policy development. She works closely with her clients to strategize on, develop and implement federal legislative and regulatory agendas.

Victoria has a robust record of advocacy on a wide range of topics including transportation and infrastructure, housing, economic development and community development, homeland security, social services, aviation, technology, public safety, preemption of local control and public finance. She specializes in positioning clients to secure federal funding through competitive grants and the appropriations process. She has developed federal legislative and regulatory priorities with mayors and city councils, analyzed the impact of legislation and regulations upon individual cities and implemented legislative strategies by liaison with relevant Congressional delegations, Congressional committees and other members of Congress.

Victoria represents clients as diverse as Miami-Dade County, the City of New Orleans, Portland (Oregon) and Las Vegas.

Before joining the firm, Victoria served as the Director of Government Affairs at a law firm, representing the interests of cities across the United States on a broad array of matters before Congress and federal agencies.

Victoria was an Assistant City Representative at the National Center for Municipal Development. She also served as the assistant to the executive director of the Democratic Study Group in the US House of Representatives and as a staff assistant to Congressman John Sieberling (D-OH).


  • Assisted in securing the first ever federally-funded streetcar project – US$75 million – under the Small Starts Program.

  • Assisted in securing federal funding for the expansion of a geothermal system for a Western city. Assisted in obtaining US$85 million for the relocation of an airport terminal in a Southern city.

  • Assisted in obtaining the only variance to a Safe Drinking Water Act regulation for a major city.

  • Assisted in preventing the recapture of Community Development Block Grant funds for a medium sized city.

Charles Brereton Public Policy Lawyer, Squire PB

Charlie Brereton is a member of our Public Policy Strategic Advocacy Practice, in which he assists a variety of clients as they navigate the federal legislative process.

Prior to becoming a public policy specialist, Charlie was chosen to participate in the firm’s rigorous public policy internship program.

As an undergraduate at The George Washington University, Charlie developed insights into both chambers of Congress through selective internships with House Speaker John Boehner (R-OH) and Senator Richard Burr (R-NC). Charlie also broadened his knowledge of state government...