Advocacy Update

Jan. 27, 2023: State Advocacy Update


State policymakers have multiple, evidence-based options to help reduce drug-related overdose and death, according to new recommendations from the AMA Advocacy Resource Center (PDF).

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The recommendations provide specific legislative and regulatory language working in select states across a range of areas: 

  • Increase access to evidence-based treatments to help patients with a substance use disorder by prohibiting prior authorization for all medications to treat opioid use disorder; requiring states to use American Society of Addiction Medicine (ASAM) criteria as the basis for evaluating medical necessity; and requiring jails and prisons to assess, treat and ensure access to evidence-based care for mental illness and substance use disorder, including for individuals who are pregnant and postpartum. 
  • Address longstanding payer-imposed barriers by requiring medical necessity determinations to be based on medical evidence and practice as well as requiring payers to comply with state and federal parity laws, including taking action to provide adequate mental health and substance use disorder provider networks. 
  • Improve access to multidisciplinary, multimodal care for patients with pain and remove all reference to arbitrary numeric thresholds as now recommended by the U.S. Centers for Disease Control and Prevention. 
  • Enhance harm reduction initiatives by removing fentanyl test strips and other testing equipment from drug paraphernalia laws; expanding naloxone access laws; and supporting pilot projects to evaluate overdose prevention sites.

A bill to decriminalize fentanyl test strips passed out of the South Dakota Judiciary Committee this week with the strong support of the South Dakota State Medical Association (SDSMA) and the AMA. House Bill 1041 says: “drug paraphernalia does not include a product that detects the presence of fentanyl or a fentanyl analog in a controlled substance.”  

The AMA and SDSMA support the bill to help people who use drugs to identify potentially deadly contamination from illicitly manufactured fentanyl, which is killing an unprecedented number of people in South Dakota and across the nation. 

The AMA also is urging the legislature to consider going beyond only "fentanyl test strips" given the increasing presence of other substances being found in illicitly manufactured pills and substances.  

"Limiting laws to only ‘fentanyl test strips,’ is a start, but it will likely miss the full picture," wrote AMA Executive Vice President and CEO James L. Madara, MD. "The AMA, therefore, urges South Dakota to take a comprehensive view of the epidemic it faces by decriminalizing fentanyl test strips, as well as other devices or other testing equipment or product used, intended for use, or designed for use in identifying or analyzing the strength, presence or purity of a controlled substance, toxic substance, or hazardous compound including, but not limited to fentanyl or fentanyl analogues."

On Jan. 12-14, more than 250 physician leaders and medical society staff joined the AMA in Marana, AZ, for the annual AMA State Advocacy Summit—held in person for the first time since 2020. Attendees discussed strategies for the upcoming year—tackling some of the toughest issues facing health care and sharing important advocacy priorities.

Sessions, which included more than 35 expert speakers, covered key health care topics that states will likely address in the coming legislative sessions: 

  • Physician wellness 
  • Scope of practice 
  • Prior authorization 
  • Telehealth  
  • The nation's overdose and death epidemic 
  • Competition and antitrust 
  • State departments of insurance 
  • Reproductive health care 
  • And more! 

For more information about the summit, visit the AMA website—and make sure to save the date for the 2024 State Advocacy Summit, Jan. 11-13 in Amelia Island, Florida.