Student and Student Athlete Opioid Misuse Prevention Act

H.R. 1611/S. 2612 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Promoting Integrity in Medicare Act H.R. 5365 Primary Health Services Enhancement Act H.R. 5216 Protecting Student Athletes from Concussions Act S. 3043 Protecting Student Athletes from Concussions Act of 2021 1115 Waivers S. 3799 PREVENT Pandemics Act H.R. 7246 Student and Student Athlete Opioid Misuse Prevention Act H.R. 3109/S. 844 Personal Health Investment Today Act H.R. 2094/S. 1301 Promoting Physical Activity for Americans Act H.R. 8181 Optimizing Postpartum Outcomes Act H.R. 5536 SMART Act

Client expense: $202,662 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), White House Office

Athlete safety; Opioid misuse/abuse prevention; Athlete trainers under Medicare program; H.R. 5216 - Protecting Student Athletes from Concussions Act; H.R. 4855 - Braedens Commission: Protect Our Athletes from Exertional Heat Stroke; Concussion Awareness and Education Act; S. 844, H.R. 3109 - The Personal Health Investment Today (PHIT) Act; S. 1301, H.R. 2094 - The Promoting Physical Activity Recommendations for Americans Act; H.R. 2841 - Student Athlete Level Playing Field Act; H.R. 7246, S. 3940 - Student and Student Athlete Opioid Misuse Prevention Act; Name, Image and Likeness issues for college athletes; H.R. 4163 - Even Playing Field Act; H.R. 3320, S. 1679 - Allied Health Workforce Diversity Act; H.R. 1899 - Ensuring Compliance Against Drug Diversion Act of 2021; H.R. 1384/S. 445 - the Synthetic Opioid Danger Awareness Act; H.R. 2355 - Opioid Prescription Verification Act; H.R. 3193 Expanded Telehealth Access Act; S. 4056/H.R. 7478 - Supporting Athletes, Families, and Educators to Protect the Lives of Athletic Youth Act; Athletic trainer salary issues; H.R. 8552 - PLAYS in Youth Sports Act; H.R. 8751 - High School Sports Injury Reporting Act.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

H.R. 1611/S. 2612 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Promoting Integrity in Medicare Act H.R. 5365 Primary Health Services Enhancement Act H.R. 5216 Protecting Student Athletes from Concussions Act S. 3043 Protecting Student Athletes from Concussions Act of 2021 1115 Waivers S. 3799 PREVENT Pandemics Act H.R. 7246 Student and Student Athlete Opioid Misuse Prevention Act H.R. 3109/S. 844 Personal Health Investment Today Act H.R. 2094/S. 1301 Promoting Physical Activity for Americans Act H.R. 8181 Optimizing Postpartum Outcomes Act

Client expense: $194,970 · Firm income: Not reported

Athlete safety; Opioid misuse/abuse prevention; Athlete trainers under Medicare program; H.R. 5216 - Protecting Student Athletes from Concussions Act; H.R. 4855 - Braedens Commission: Protect Our Athletes from Exertional Heat Stroke; Concussion Awareness and Education Act; S. 844, H.R. 3109 - The Personal Health Investment Today (PHIT) Act; S. 1301, H.R. 2094 - The Promoting Physical Activity Recommendations for Americans Act; H.R. 2841 - Student Athlete Level Playing Field Act; H.R. 7246, S. 3940 - Student and Student Athlete Opioid Misuse Prevention Act; Name, Image and Likeness issues for college athletes; H.R. 4163 - Even Playing Field Act; H.R. 3320, S. 1679 - Allied Health Workforce Diversity Act; H.R. 1899 - Ensuring Compliance Against Drug Diversion Act of 2021; H.R. 1384/S. 445 - the Synthetic Opioid Danger Awareness Act; H.R. 2355 - Opioid Prescription Verification Act; H.R. 3193 Expanded Telehealth Access Act; S. 4056/H.R. 7478 - Supporting Athletes, Families, and Educators to Protect the Lives of Athletic Youth Act.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1611/S. 2612 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Promoting Integrity in Medicare Act H.R. 5365 Primary Health Services Enhancement Act H.R. 5216 Protecting Student Athletes from Concussions Act S. 3043 Protecting Student Athletes from Concussions Act of 2021 1115 Waivers S. 3799 PREVENT Pandemics Act H.R. 7246 Student and Student Athlete Opioid Misuse Prevention Act H.R. 3109/S. 844 Personal Health Investment Today Act H.R. 2094/S. 1301 Promoting Physical Activity for Americans Act H.R. 8181 Optimizing Postpartum Outcomes Act

Client expense: $195,457 · Firm income: Not reported

H.R. 1611/S. 2612 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Promoting Integrity in Medicare Act H.R. 5365 Primary Health Services Enhancement Act H.R. 5216 Protecting Student Athletes from Concussions Act S. 3043 Protecting Student Athletes from Concussions Act of 2021 1115 Waivers S. 3799 PREVENT Pandemics Act H.R. 7246 Student and Student Athlete Opioid Misuse Prevention Act H.R. 3109/S. 844 Personal Health Investment Today Act H.R. 2094/S. 1301 Promoting Physical Activity for Americans Act

Client expense: $236,616 · Firm income: Not reported

Athlete safety; Opioid misuse/abuse prevention; Athlete trainers under Medicare program; H.R. 5216 - Protecting Student Athletes from Concussions Act; H.R. 4855 - Braedens Commission: Protect Our Athletes from Exertional Heat Stroke; Concussion Awareness and Education Act; S. 844, H.R. 3109 - The Personal Health Investment Today (PHIT) Act; S. 1301, H.R. 2094 - The Promoting Physical Activity Recommendations for Americans Act; H.R. 2841 - Student Athlete Level Playing Field Act; H.R. 7246, S. 3940 - Student and Student Athlete Opioid Misuse Prevention Act; Name, Image and Likeness issues for college athletes; H.R. 4163 - Even Playing Field Act; H.R. 3320, S. 1679 - Allied Health Workforce Diversity Act; H.R. 1899 - Ensuring Compliance Against Drug Diversion Act of 2021; H.R. 1384/S. 445 - the Synthetic Opioid Danger Awareness Act; H.R. 2355 - Opioid Prescription Verification Act; H.R. 3193 Expanded Telehealth Access Act.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES

Issues related to athletic scholarships, health and safety, gender equity, academic success, the collegiate athletic model, amateurism and the governance and the regulatory process of college sports. H.R.7246 - Student and Student Athlete Opioid Misuse Prevention Act; S.3940 - Student and Student Athlete Opioid Misuse Prevention Act.

Client expense: $130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

HR 7246 - Student and Student Athlete Opioid Misuse Prevention Act - would create a new grant program in the Substance Abuse and Mental Health Services Administration for preventing the misuse of opioids and other drugs used in pain management among high school and college student athletes S 3940 - Student and Student Athlete Opioid Misuse Prevention Act - would create a new grant program in the Substance Abuse and Mental Health Services Administration for preventing the misuse of opioids and other drugs used in pain management among high school and college student athletes S. XXXX - A bill to amend the Controlled Substances Act to modify the definition of counterfeit substance and for other purposes. This bill has not been introduced, so it does not have a bill number. The potential bill would introduce a definition of counterfeit fentanyl pill and give expanded law enforcement authority for dealing with he issue. The bill would establish a day of awareness in May to help promote educational efforts around the issue

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE