April 6, 2017: State Advocacy Update

The AMA Task Force to Reduce Opioid Abuse this week released a new recommendation urging physicians to make increased efforts to raise awareness about safe storage and disposal of expired, unwanted or unused medications. The recommendations emphasize three steps for physicians to take:

• Talk to your patients and educate them about safe use of prescription opioids to help prevent misuse and diversion.
• Remind patients that medications should be stored out of reach of children and in a safe place.
• Urge patients to safely dispose of expired, unwanted and unused medications.

The task force also pointed to several resources that physicians and patients can use to search for drug disposal locations.

To download a copy (PDF) of the new task force recommendation and to learn more, visit this webpage on safe storage and disposal of opioids.

More than 10,000 physicians have become trained in the past 12 months to provide in-office buprenorphine to treat patients with substance-use disorders, according to the most recent Substance Abuse and Mental Health Services Administration data. Encouraging more physicians to become trained to treat substance-use disorders is a top recommendation of the AMA Task Force to Reduce Opioid Abuse.

"This is an excellent reflection on the efforts of physicians to educate themselves about treatment and also to potentially increase access to treatment," Dr. Harris said. "We need to continue the momentum and reduce barriers to patients accessing treatment, including urging all public and private payers to remove administrative barriers such as prior authorization for medication-assisted treatment."

In addition, more than 3,000 physicians have become certified in the past 12 months to provide MAT for up to 275 patients. This is significant because, for years, physicians could only provide MAT for up to 100 patients, but advocacy from the AMA and many other physician organizations led to a provision in the 2016 Comprehensive Addiction and Recovery Act to increase the patient cap to 275.

On March 30, Kansas Gov. Sam Brownback vetoed House Bill 2044, which would have expanded Medicaid eligibility under the ACA. The bill passed both houses of the legislature with bipartisan support. In his veto message, the governor said the bill would overburden the state budget. Under the ACA, the federal government currently pays 95 percent of the cost of Medicaid expansion, which will drop to 90 percent by 2020. Medicaid expansion would bring coverage to about 180,000 low-income adults in Kansas.

In Arkansas, lawmakers voted to reauthorize the state's alternative Medicaid expansion program known as Arkansas Works. Each year, the legislature must reauthorize the program by a three-fourths vote. This year, the bill underwent three separate votes before it garnered the supermajority needed. During a special session in May, the legislature will take up proposed changes to the Medicaid program sought by Gov. Asa Hutchinson, such as work requirements for non-disabled Medicaid enrollees.

To date, 31 states and the District of Columbia have expanded Medicaid to cover adults with incomes up to 138 percent of the poverty level. For additional information about this and other Medicaid issues, contact the AMA Advocacy Resource Center.

The Tennessee legislature last week passed a bill that aims to reduce the frequency and impact of changes to physician-insurer contracts on physician practices. The Tennessee Medical Association (TMA) worked for nearly four years to pass legislation addressing the constant contractual changes that affect the financial stability of physician practices. The final version of Senate Bill 437, the Healthcare Provider Stability Act, creates more predictability to payment by limiting changes to fee schedules or payment methodologies to one in a 12-month period. The bill also requires a 60-day notice of any payment policy changes. The AMA worked closely with TMA in its strong effort to pass this legislation.

• April 6, 2017: National Advocacy Update