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Congress Takes Aim at Opioid Crisis With Telehealth Expansion

The massive opioid crisis response legislation now headed to President Trump's desk includes several provisions to expand telehealth and telemedicine services to treat substance abuse and mental health issues.

Source: ThinkStock

By Eric Wicklund

- Telehealth and Telemedicine programs that assist healthcare providers in treating people with substance abuse issues will be getting a significant upgrade, thanks to a massive bill passed by Congress and headed to President Donald Trump’s desk.

Included in the SUPPORT for Patients and Communities Act (H.R. 6) are provisions to improve Medicare reimbursement for telehealth programs and support an innovative telemedicine-based program that trains rural and remote healthcare providers on how to treat patients with substance abuse and mental health issues. Several other provisions open the door to the use of connected care platforms to expand treatment to underserved populations.

“Today's final passage of the SUPPORT for Patients and Communities Act marks a watershed moment in the fight to combat the devastating opioid crisis and spare more lives from the pain of substance abuse. Health IT Now's Opioid Safety Alliance fought hard for the inclusion of data-driven, 21st-Century solutions to address this public health emergency - and won,” Joel White, Executive Director of Health IT Now’s Opioid Safety Alliance, formed earlier this year to lobby for inclusion of health IT and connected care programs in the bill, said in a press release

“We are grateful to lawmakers for including OSA-endorsed language in this bill to remove bureaucratic barriers to vital telehealth services for those suffering from addiction, modernize prescribing practices for controlled substances, incentivize the uptake of electronic health records, and streamline prior authorization claims to improve efficiency while enhancing patient safety,” he added.

The 660-page bill and 27-page executive summary includes elements of dozens of bills submitted by legislators over the past year, all aiming to tackle a national epidemic that kills an estimated 175 Americans each day.

READ MORE: Using Telehealth to Coordinate Care for Substance Abuse Disorders

One section is dedicated to enhancing Medicare reimbursement for connected health platforms for substance abuse treatment. Among other things, it would

  1. Eliminate geographic restrictions placed on services “to an eligible telehealth individual with a substance use disorder diagnosis for purposes of treatment of such disorder or co-occurring mental health disorder;” and
  2. Require a report from the Health and Human Services Department within five years on the effectiveness of telehealth and telemedicine programs in treating people with substance abuse issues.

Senator Brian Schatz (D-Hawaii), a longtime advocate for telehealth services, also praised the bill, which contains elements of bills that he’d introduced this year. This includes funding to train healthcare professionals on Project Extension for Community Health Outcomes (ECHO), a care model in which providers meet regularly through a telehealth platform to learn from specialists and share their challenges in treating patients.

“Opioid addiction is a national epidemic, and we need a comprehensive approach to address it,” he said in a press release. “Our bill will use technology to help connect health care professionals with more patients and help providers access the continuing education they need to treat addiction. It also invests in more research to find alternative treatments for pain so that we can try to stop opioid addiction before it starts.”

Among those now using the platform is Virginia Commonwealth University, which is partnering with Virginia Tech and the University of Virginia in a telemedicine programs spanning the state.

“It’s a fantastic way of delivering healthcare in a learning environment,” Dr. Vimal Mishra, Medical Director of the Office of Telemedicine/Telehealth at Virginia Commonwealth University’s VCU Health system and the principal investigator for the ECHO program, told mHealthIntelligence earlier this year. “This is where the future of public health begins.”

READ MORE: Telepsychiatry Opens a New Window into Behavioral Healthcare

The bill also clears the way for Medicare coverage of more providers to use Medication Assisted Treatment (MAT) therapy, which combines mental health treatment with carefully managed prescriptions of either Methadone, Naltrexone or Buprenorphine, all designed to help those with addiction issues get through the withdrawal stage.

Telehealth and telemedicine can enhance these programs by allowing healthcare providers to gain federal certification to administer these drugs through a virtual program like Project ECHO. In addition, a connected care platform could be used to reach underserved populations, including those in remote and rural areas with little access to in-person treatment.

The bill also permits the Attorney General and HHS Secretary to issue a special registration to healthcare providers to prescribe controlled substances via telemedicine in legitimate emergency situations, such as a lack of access to an in-person specialist.

President Trump is expected to sign the legislation soon. A press release issued by the White House today signaled his support for the bill.

“The SUPPORT for Patients and Communities Act (H.R. 6) makes important investments that will lift people out of addiction, help keep illicit drugs out of our communities, expand public awareness and prevention initiatives to stop addiction before it starts, and save lives,” he said.

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