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Senate Overwhelmingly Clears Bipartisan Opioid Package

Nearly three months following House passage of a legislative proposal related to America’s opioid epidemic, the Senate overwhelmingly cleared its own comprehensive, bipartisan package to address the crisis.

On Monday, September 17, senators replaced the House-passed text with a substitute amendment and approved The Opioid Crisis Response Act of 2018 (H.R. 6) by a vote of 99-1. The bill, authored by Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN), resulted from more than 70 pieces of legislation recommended by members of five different committees: Banking, Housing, and Urban Development; Commerce; Finance; HELP; and Judiciary.

Key provisions of the legislation, as outlined by the Senate HELP Committee’s Section-by-Section summary, would:

  • Further thwart illegal drugs, including fentanyl, from crossing US borders

  • Encourage the research, development and fast-track approvals of new, non-addictive painkillers

  • Require special safety packaging for opioids, such as three- or seven-day supply plastic “blister packs”

  • Expand Medication-Assisted Treatment (MAT) usage

  • Improve state Prescription Drug Monitoring Programs

  • Further access to behavioral and mental health providers

  • Develop comprehensive opioid recovery centers that provide housing, job training and medically supervised withdrawal management

  • Better address maternal opioid use and related infant complications

  • Promote early intervention tools for vulnerable, trauma-exposed youth

According to the Congressional Budget Office’s (CBO) latest cost estimate, H.R. 6 would authorize nearly US$7.9 billion of appropriations for crisis-related programs at US Department of Health and Human Services agencies, including the Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, and Administration for Children and Families. An updated CBO analysis is soon expected.

While the Senate bill largely mirrors its House counterpart, negotiations have ensued due to several controversial, House-incorporated provisions. These include, but are not limited to: (1) partially repealing the Medicaid Institutions for Mental Diseases (IMD) exclusion, which generally restricts federal reimbursements for care provided at substance abuse treatment facilities with more than 16 beds, and was designed to gradually eliminate older psychiatric wards; (2) loosening privacy protections for certain substance-use disorder patient records; and (3) permanently authorizing nurse practitioners and physician assistants to prescribe US Food and Drug Administration-approved MAT drugs under the direction of a qualified physician.

Despite several weeks of pre-conference discussions, both chambers continue to reconcile differences between their landmark legislative packages. Congressional leaders, including Committee Chairman Alexander, have expressed optimism that a final agreement will be offered, approved and signed into law prior to the 2018 midterm elections.

© 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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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 and politics at the executive level while interning with North Carolina Governor Pat McCrory (R).

Additionally, he cultivated an understanding of the US healthcare system through his undergraduate coursework and by participating in a competitive internship program at Blue Cross Blue Shield Association. While working at BCBSA’s Office of Policy and Representation in Washington DC, Charlie played a role in federal and state advocacy efforts on behalf of the nation’s largest network of health insurers. He also researched Affordable Care Act implementation and its impact on the health insurance industry, as well as supported policy advisers during the development of corporate initiatives to manage and prevent opioid abuse.

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...