May 4, 2017: State Advocacy Update

AMA Opioid Task Force progress report

As part of its efforts to advocate that physicians take a leadership role in reversing the nation's opioid epidemic, the AMA Opioid Task Force also is committed to measuring the efforts of physicians across several key areas identified by policymakers and public health experts as being part of a comprehensive solution:

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PDMPs: Physicians and other health care professionals queried their state prescription drug-monitoring program (PDMP) more than 136 million times in 2016—a 121 percent increase over 2014. Registration to use state PDMPs has nearly tripled since 2014, to more than 1.3 million registered users in 2016.
Education: In 2015 and 2016, more than 118,000 physicians accessed, attended or completed continuing medical educational and other courses on safe opioid prescribing, pain management, addiction and related areas. The courses were offered by the AMA, American Osteopathic Association, American Dental Association and the nation's state and specialty societies.
Treatment: More than 37,000 physicians now are certified to provide office-based, medication-assisted treatment for opioid use disorders across all 50 states. More than 10,000 have earned this certification in the past year.
Opioid prescribing: While there remains work to do in ensuring comprehensive treatment for patients with pain, there was a national 17 percent decrease in opioid prescribing from 2012 to 2016, with decreases seen in every state.
Naloxone: Nearly all 50 states now have naloxone-access laws. In the first two months of 2017, more than 32,000 naloxone prescriptions were dispensed, a record 340 percent increase from 2016.

"These are good signs of progress, but to truly reverse the nation's opioid epidemic, we all have much more work to do," said Patrice A. Harris, MD, MA, chair of the AMA Board of Trustees, and chair of the AMA Opioid Task Force.

New York offers free buprenorphine training

The New York State Department of Health, AIDS Institute recently announced a "Free Buprenorphine Waiver Training for Clinical Providers" in multiple locations throughout the state. The AMA and the Medical Society of the State of New York strongly support physicians becoming trained to provide buprenorphine to their patients as part of a comprehensive plan to increase treatment for patients with substance use disorders.

The upcoming trainings will be in Monticello (PDF) (May 6), Plattsburgh (PDF) (May 20) and Ithaca (PDF) (June 3). Free buprenorphine waiver trainings also are offered throughout all five New York City boroughs. For further information, please send an email to [email protected]. Find more information about all upcoming MAT trainings.

"Give Me a Shot" campaign defeats anti-vaccine bills in Mississippi

Developed by the Mississippi State Medical Association, the "Give Me a Shot" campaign successfully defeated six anti-vaccine bills this year in the Mississippi legislature. Mississippi has one of the nation's strongest immunization policies and does not permit exemption from required immunizations for religious, philosophical or conscientious reasons. The defeated legislation would have changed state law to allow vaccine exemptions for these reasons, in addition to standard medical exemptions.

The "Give Me A Shot" campaign is a comprehensive grassroots advocacy campaign designed to garner public support for pro-vaccine advocacy and to provide public and government leaders with accurate, evidence-based information on the benefits of immunization and the role policy plays in protecting against preventable diseases. The campaign mobilized those who have a vested interest in children's health—parents and community members, health care providers, legislators and public officials—into a diverse pool of grassroots advocates in support of strong vaccination policies with the tools and knowledge necessary to impact change.

The campaign included educational resources for parents, talking points for legislators, social media content, media and more. Additional information can be found at GiveMeAShot.org and materials are available for download via Dropbox. For additional information about immunization laws in your state, contact the AMA Advocacy Resource Center.

Wisconsin seeks novel changes to Medicaid program

On April 19, the Wisconsin Department of Health Services released a Section 1115 Demonstration Waiver proposal, known as the BadgerCare Reform Demonstration Waiver, to restructure the state's Medicaid program for childless adults living at or below the poverty line. Section 1115 Demonstration Waivers allow state Medicaid programs to put aside certain federal Medicaid requirements in order to test and evaluate a new delivery model and also receive federal matching funds. The federal government must approve the waiver before it can be implemented.

Wisconsin's waiver proposal would require certain Medicaid enrollees to pay monthly premiums in addition to existing copayments and reward healthy behaviors with reduced cost sharing. The waiver would also require, as a condition of enrollment, that certain enrollees submit to drug testing. Those who test positive for drug use would be required to participate in a substance-use disorder (SUD) treatment program. Wisconsin also seeks to limit enrollment to 48 cumulative months for enrollees not working or participating in a training program.

In addition, the waiver proposal seeks to expand treatment options for all Medicaid enrollees with SUD. If approved, the program would provide full coverage for residential SUD treatment for individuals in institutes for mental diseases (IMD). Federal law currently prohibits states from receiving reimbursement for services provided by IMDs.

The Wisconsin Department of Health Services is seeking public comment on the waiver through May 19, 2017. For additional information about state Medicaid programs, contact the AMA Advocacy Resource Center.