Humane Correctional Health Care Act

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 H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. 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 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 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; 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. Advocated for 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 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. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

Client expense: $70,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

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 H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. 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 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 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; 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. Advocated for 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 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. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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 H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. 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 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 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; 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. Advocated for 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 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. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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 H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. 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 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 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; 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. Advocated for 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 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. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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 H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. 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 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 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; 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. Advocated for 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 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. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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 H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. 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 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 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; 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. Advocated for 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 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. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

Preserve Medicaid and Affordable Care Act Medicaid expansion. Preserve Medicaid funding and Medicaid disproportionate share hospital payments. Support easing the Medicaid IMD exclusion including support for the Increasing Behavioral Health Treatment Act (H.R. 2611). Support easing the Medicaid inmate exclusion, including support for the Humane Correctional Health Care Act (S. 1821/H.R. 3514). Support protecting the Medicaid program and the Affordable Care Act, including the Medicaid expansion. Support H.R. 2297, Meeting IMD Needs with Direction Act/MIND Act to lift the Medicaid IMD exclusion for the duration of the public health emergency plus 180 days. Support H.R. 955, S. 285, Medicaid Reentry Act to permit Medicaid coverage for inmates 30 days prior to release. Support similar provisions in H.R. 5376, Build Back Better Act. Support measures to phase down enhanced FMAP after COVID public health emergency ends.

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), 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.

Preserve Medicaid and Affordable Care Act Medicaid expansion. Preserve Medicaid funding and Medicaid disproportionate share hospital payments. Support easing the Medicaid IMD exclusion including support for the Increasing Behavioral Health Treatment Act (H.R. 2611). Support easing the Medicaid inmate exclusion, including support for the Humane Correctional Health Care Act (S. 1821/H.R. 3514). Support protecting the Medicaid program and the Affordable Care Act, including the Medicaid expansion. Support H.R. 2297, Meeting IMD Needs with Direction Act/MIND Act to lift the Medicaid IMD exclusion for the duration of the public health emergency plus 180 days. Support H.R. 955, S. 285, Medicaid Reentry Act to permit Medicaid coverage for inmates 30 days prior to release. Support similar provisions in H.R. 5376, Build Back Better Act.

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), 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 changes to a draft opioid treatment program bill to 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 inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee 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. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes. Joined advocacy coalition letter to Chairman Ron Wyden and Ranking Member Mike Crapo of the 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 Advocated for addiction-related provisions in the Build Back Better Act (BBBA) that would increase access to comprehensive, high-quality addiction care in ways that reduce racial, ethnic, and economic disparities, and make important investments in the addiction medicine workforce. Sent letter to the FDA responding to their request for feedback in reevaluating the voluntary status of the Opioid Analgesics (OA) Risk Evaluation and Mitigation Strategy (REMS) program. Currently, FDA is considering extending the REMS program to become a mandatory course for all opioid prescribers. Urged against FDA making the REMS program mandatory for all opioid prescribers and identified other strategies to expand provider education more effectively. Primarily, ASAM emphasized the importance of the concurrent passage of the Medication Access and Training Expansion (MATE) Act (S 2235/HR 2067) and the Mainstreaming Addiction Treatment (MAT) Act (S 445/HR 1384). Advocated for the HR 6279, the Opioid Treatment Access Act that would allow for broader access to methadone for opioid use disorder, including through measured expansion of prescribing/pharmacy dispensing. Joined coalition letter urging reconsideration of the requirements in the Interim Final Rule (IFR), entitled Requirements Related to Surprise Billing; Part II, 86 Fed. Reg. 55,980 (Oct. 7, 2021), implementing the No Surprises Act (NSA) that directs Independent Dispute Resolution (IDR) entities to consider the qualifying payment amount (QPA) a rebuttable presumptive reasonable payment for out-of-network physicians engaging in the IDR process. Joined coalition letter urging inclusion of provisions in the Administration's budget request for FY 23 that expand the Administrations efforts to reduce tobacco use, which remains the leading preventable cause of death in the United States. 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

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 changes to a draft opioid treatment program bill to 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 inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee 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. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes. Joined advocacy coalition letter to Chairman Ron Wyden and Ranking Member Mike Crapo of the 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 Advocated for addiction-related provisions in the Build Back Better Act (BBBA) that would increase access to comprehensive, high-quality addiction care in ways that reduce racial, ethnic, and economic disparities, and make important investments in the addiction medicine workforce. Sent letter to the FDA responding to their request for feedback in reevaluating the voluntary status of the Opioid Analgesics (OA) Risk Evaluation and Mitigation Strategy (REMS) program. Currently, FDA is considering extending the REMS program to become a mandatory course for all opioid prescribers. Urged against FDA making the REMS program mandatory for all opioid prescribers and identified other strategies to expand provider education more effectively. Primarily, ASAM emphasized the importance of the concurrent passage of the Medication Access and Training Expansion (MATE) Act (S 2235/HR 2067) and the Mainstreaming Addiction Treatment (MAT) Act (S 445/HR 1384). Advocated for the HR 6279, the Opioid Treatment Access Act that would allow for broader access to methadone for opioid use disorder, including through measured expansion of prescribing/pharmacy dispensing. Joined coalition letter urging reconsideration of the requirements in the Interim Final Rule (IFR), entitled Requirements Related to Surprise Billing; Part II, 86 Fed. Reg. 55,980 (Oct. 7, 2021), implementing the No Surprises Act (NSA) that directs Independent Dispute Resolution (IDR) entities to consider the qualifying payment amount (QPA) a rebuttable presumptive reasonable payment for out-of-network physicians engaging in the IDR process. Joined coalition letter urging inclusion of provisions in the Administration's budget request for FY 23 that expand the Administrations efforts to reduce tobacco use, which remains the leading preventable cause of death in the United States. 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

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 changes to a draft opioid treatment program bill to 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 inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee 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. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes. Joined advocacy coalition letter to Chairman Ron Wyden and Ranking Member Mike Crapo of the 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 Advocated for addiction-related provisions in the Build Back Better Act (BBBA) that would increase access to comprehensive, high-quality addiction care in ways that reduce racial, ethnic, and economic disparities, and make important investments in the addiction medicine workforce. Sent letter to the FDA responding to their request for feedback in reevaluating the voluntary status of the Opioid Analgesics (OA) Risk Evaluation and Mitigation Strategy (REMS) program. Currently, FDA is considering extending the REMS program to become a mandatory course for all opioid prescribers. Urged against FDA making the REMS program mandatory for all opioid prescribers and identified other strategies to expand provider education more effectively. Primarily, ASAM emphasized the importance of the concurrent passage of the Medication Access and Training Expansion (MATE) Act (S 2235/HR 2067) and the Mainstreaming Addiction Treatment (MAT) Act (S 445/HR 1384). Advocated for the HR 6279, the Opioid Treatment Access Act that would allow for broader access to methadone for opioid use disorder, including through measured expansion of prescribing/pharmacy dispensing. Joined coalition letter urging reconsideration of the requirements in the Interim Final Rule (IFR), entitled Requirements Related to Surprise Billing; Part II, 86 Fed. Reg. 55,980 (Oct. 7, 2021), implementing the No Surprises Act (NSA) that directs Independent Dispute Resolution (IDR) entities to consider the qualifying payment amount (QPA) a rebuttable presumptive reasonable payment for out-of-network physicians engaging in the IDR process. Joined coalition letter urging inclusion of provisions in the Administration's budget request for FY 23 that expand the Administrations efforts to reduce tobacco use, which remains the leading preventable cause of death in the United States. 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

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 changes to a draft opioid treatment program bill to 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 inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee 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. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes. Joined advocacy coalition letter to Chairman Ron Wyden and Ranking Member Mike Crapo of the 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 Advocated for addiction-related provisions in the Build Back Better Act (BBBA) that would increase access to comprehensive, high-quality addiction care in ways that reduce racial, ethnic, and economic disparities, and make important investments in the addiction medicine workforce. Sent letter to the FDA responding to their request for feedback in reevaluating the voluntary status of the Opioid Analgesics (OA) Risk Evaluation and Mitigation Strategy (REMS) program. Currently, FDA is considering extending the REMS program to become a mandatory course for all opioid prescribers. Urged against FDA making the REMS program mandatory for all opioid prescribers and identified other strategies to expand provider education more effectively. Primarily, ASAM emphasized the importance of the concurrent passage of the Medication Access and Training Expansion (MATE) Act (S 2235/HR 2067) and the Mainstreaming Addiction Treatment (MAT) Act (S 445/HR 1384). Advocated for the HR 6279, the Opioid Treatment Access Act that would allow for broader access to methadone for opioid use disorder, including through measured expansion of prescribing/pharmacy dispensing. Joined coalition letter urging reconsideration of the requirements in the Interim Final Rule (IFR), entitled Requirements Related to Surprise Billing; Part II, 86 Fed. Reg. 55,980 (Oct. 7, 2021), implementing the No Surprises Act (NSA) that directs Independent Dispute Resolution (IDR) entities to consider the qualifying payment amount (QPA) a rebuttable presumptive reasonable payment for out-of-network physicians engaging in the IDR process. Joined coalition letter urging inclusion of provisions in the Administration's budget request for FY 23 that expand the Administrations efforts to reduce tobacco use, which remains the leading preventable cause of death in the United States. 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

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 changes to a draft opioid treatment program bill to 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 inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee 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. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes. Joined advocacy coalition letter to Chairman Ron Wyden and Ranking Member Mike Crapo of the 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 Advocated for addiction-related provisions in the Build Back Better Act (BBBA) that would increase access to comprehensive, high-quality addiction care in ways that reduce racial, ethnic, and economic disparities, and make important investments in the addiction medicine workforce. Sent letter to the FDA responding to their request for feedback in reevaluating the voluntary status of the Opioid Analgesics (OA) Risk Evaluation and Mitigation Strategy (REMS) program. Currently, FDA is considering extending the REMS program to become a mandatory course for all opioid prescribers. Urged against FDA making the REMS program mandatory for all opioid prescribers and identified other strategies to expand provider education more effectively. Primarily, ASAM emphasized the importance of the concurrent passage of the Medication Access and Training Expansion (MATE) Act (S 2235/HR 2067) and the Mainstreaming Addiction Treatment (MAT) Act (S 445/HR 1384). Advocated for the HR 6279, the Opioid Treatment Access Act that would allow for broader access to methadone for opioid use disorder, including through measured expansion of prescribing/pharmacy dispensing. Joined coalition letter urging reconsideration of the requirements in the Interim Final Rule (IFR), entitled Requirements Related to Surprise Billing; Part II, 86 Fed. Reg. 55,980 (Oct. 7, 2021), implementing the No Surprises Act (NSA) that directs Independent Dispute Resolution (IDR) entities to consider the qualifying payment amount (QPA) a rebuttable presumptive reasonable payment for out-of-network physicians engaging in the IDR process. Joined coalition letter urging inclusion of provisions in the Administration's budget request for FY 23 that expand the Administrations efforts to reduce tobacco use, which remains the leading preventable cause of death in the United States. 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

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 changes to a draft opioid treatment program bill to 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 inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee 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. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes. Joined advocacy coalition letter to Chairman Ron Wyden and Ranking Member Mike Crapo of the 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 Advocated for addiction-related provisions in the Build Back Better Act (BBBA) that would increase access to comprehensive, high-quality addiction care in ways that reduce racial, ethnic, and economic disparities, and make important investments in the addiction medicine workforce. Sent letter to the FDA responding to their request for feedback in reevaluating the voluntary status of the Opioid Analgesics (OA) Risk Evaluation and Mitigation Strategy (REMS) program. Currently, FDA is considering extending the REMS program to become a mandatory course for all opioid prescribers. Urged against FDA making the REMS program mandatory for all opioid prescribers and identified other strategies to expand provider education more effectively. Primarily, ASAM emphasized the importance of the concurrent passage of the Medication Access and Training Expansion (MATE) Act (S 2235/HR 2067) and the Mainstreaming Addiction Treatment (MAT) Act (S 445/HR 1384). Advocated for the HR 6279, the Opioid Treatment Access Act that would allow for broader access to methadone for opioid use disorder, including through measured expansion of prescribing/pharmacy dispensing. Joined coalition letter urging reconsideration of the requirements in the Interim Final Rule (IFR), entitled Requirements Related to Surprise Billing; Part II, 86 Fed. Reg. 55,980 (Oct. 7, 2021), implementing the No Surprises Act (NSA) that directs Independent Dispute Resolution (IDR) entities to consider the qualifying payment amount (QPA) a rebuttable presumptive reasonable payment for out-of-network physicians engaging in the IDR process. Joined coalition letter urging inclusion of provisions in the Administration's budget request for FY 23 that expand the Administrations efforts to reduce tobacco use, which remains the leading preventable cause of death in the United States. 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

Preserve Medicaid and Affordable Care Act Medicaid expansion. Preserve Medicaid funding and Medicaid disproportionate share hospital payments. Support easing the Medicaid IMD exclusion including support for the Increasing Behavioral Health Treatment Act (H.R. 2611). Support easing the Medicaid inmate exclusion, including support for the Humane Correctional Health Care Act (S. 1821/H.R. 3514). Support protecting the Medicaid program and the Affordable Care Act, including the Medicaid expansion. Support H.R. 2297, Meeting IMD Needs with Direction Act/MIND Act to lift the Medicaid IMD exclusion for the duration of the public health emergency plus 180 days. Support H.R. 955, S. 285, Medicaid Reentry Act to permit Medicaid coverage for inmates 30 days prior to release. Support similar provisions in H.R. 5376, Build Back Better Act.

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), 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 House Resolution 349, which would support the goals of Overdose Awareness Day by lowering the United States flag to halfstaff on all Federal buildings on August 31st of each year. 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 changes to a draft opioid treatment program bill to 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 Submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) outlining suggested improvements to the proposed Physician Payment Schedule for calendar year (CY) 2022. Among other recommendations, ASAM urged that CMS work with Congress to avoid a 2.5% cut in reimbursements for addiction medicine (ADM), finalize coding and payment rules for take-home naloxone nasal spray, and extend audio-only flexibility for opioid treatment programs (OTPs) to furnish therapy and counseling payments for substance use disorder (SUD). Advocated for the inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 nomination of Dr. Rahul Gupta to lead the Office of National Drug Control Policy (ONDCP), a critical position for coordinating the nations drug policy and response to the nations drug addiction and overdose crisis. Supported the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 2069/H.R. 4323). This legislation would allow for every state and territory the ability to join the Certified Community Behavioral Health Clinic (CCBHC) demonstration and would authorize investments in the model for current and prospective CCBHCs. 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). Advocated for H.R. 2786/ S. 1314, the Tobacco Tax Equity Act of 2021, which would increase the federal excise tax on cigarettes and set federal tax rates for other tobacco products at an equivalent level. Supported the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee Advocated for passage of the Advancing FASD Research, Services, and Prevention Act (S.2238 and H.R.4151), known as the FASD Respect Act. The legislation would in part reauthorize and strengthen existing federal FASD programs at NIAAA, CDC, and HRSA, and for the first time calls for long-neglected, meaningful support for individuals and families living with FASD. 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. Supported the National Committee on Vital and Health Statistics (NCVHS) efforts to enhance the exchange of clinical and administrative data through their recommendations to the Secretary but highlighted the important role of the Current Procedural Terminology (CPT) code set as serving the needs of a data-driven health system by allowing physicians, patients, researchers, medical groups, allied health care professionals, health systems, hospitals, medical coders, accreditation organizations, payers, and health information technology professionals to easily exchange data on the medical services and procedures provided to patients. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes.

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 House Resolution 349, which would support the goals of Overdose Awareness Day by lowering the United States flag to halfstaff on all Federal buildings on August 31st of each year. 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 changes to a draft opioid treatment program bill to 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 Submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) outlining suggested improvements to the proposed Physician Payment Schedule for calendar year (CY) 2022. Among other recommendations, ASAM urged that CMS work with Congress to avoid a 2.5% cut in reimbursements for addiction medicine (ADM), finalize coding and payment rules for take-home naloxone nasal spray, and extend audio-only flexibility for opioid treatment programs (OTPs) to furnish therapy and counseling payments for substance use disorder (SUD). Advocated for the inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 nomination of Dr. Rahul Gupta to lead the Office of National Drug Control Policy (ONDCP), a critical position for coordinating the nations drug policy and response to the nations drug addiction and overdose crisis. Supported the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 2069/H.R. 4323). This legislation would allow for every state and territory the ability to join the Certified Community Behavioral Health Clinic (CCBHC) demonstration and would authorize investments in the model for current and prospective CCBHCs. 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). Advocated for H.R. 2786/ S. 1314, the Tobacco Tax Equity Act of 2021, which would increase the federal excise tax on cigarettes and set federal tax rates for other tobacco products at an equivalent level. Supported the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee Advocated for passage of the Advancing FASD Research, Services, and Prevention Act (S.2238 and H.R.4151), known as the FASD Respect Act. The legislation would in part reauthorize and strengthen existing federal FASD programs at NIAAA, CDC, and HRSA, and for the first time calls for long-neglected, meaningful support for individuals and families living with FASD. 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. Supported the National Committee on Vital and Health Statistics (NCVHS) efforts to enhance the exchange of clinical and administrative data through their recommendations to the Secretary but highlighted the important role of the Current Procedural Terminology (CPT) code set as serving the needs of a data-driven health system by allowing physicians, patients, researchers, medical groups, allied health care professionals, health systems, hospitals, medical coders, accreditation organizations, payers, and health information technology professionals to easily exchange data on the medical services and procedures provided to patients. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes.

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 House Resolution 349, which would support the goals of Overdose Awareness Day by lowering the United States flag to halfstaff on all Federal buildings on August 31st of each year. 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 changes to a draft opioid treatment program bill to 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 Submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) outlining suggested improvements to the proposed Physician Payment Schedule for calendar year (CY) 2022. Among other recommendations, ASAM urged that CMS work with Congress to avoid a 2.5% cut in reimbursements for addiction medicine (ADM), finalize coding and payment rules for take-home naloxone nasal spray, and extend audio-only flexibility for opioid treatment programs (OTPs) to furnish therapy and counseling payments for substance use disorder (SUD). Advocated for the inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 nomination of Dr. Rahul Gupta to lead the Office of National Drug Control Policy (ONDCP), a critical position for coordinating the nations drug policy and response to the nations drug addiction and overdose crisis. Supported the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 2069/H.R. 4323). This legislation would allow for every state and territory the ability to join the Certified Community Behavioral Health Clinic (CCBHC) demonstration and would authorize investments in the model for current and prospective CCBHCs. 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). Advocated for H.R. 2786/ S. 1314, the Tobacco Tax Equity Act of 2021, which would increase the federal excise tax on cigarettes and set federal tax rates for other tobacco products at an equivalent level. Supported the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee Advocated for passage of the Advancing FASD Research, Services, and Prevention Act (S.2238 and H.R.4151), known as the FASD Respect Act. The legislation would in part reauthorize and strengthen existing federal FASD programs at NIAAA, CDC, and HRSA, and for the first time calls for long-neglected, meaningful support for individuals and families living with FASD. 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. Supported the National Committee on Vital and Health Statistics (NCVHS) efforts to enhance the exchange of clinical and administrative data through their recommendations to the Secretary but highlighted the important role of the Current Procedural Terminology (CPT) code set as serving the needs of a data-driven health system by allowing physicians, patients, researchers, medical groups, allied health care professionals, health systems, hospitals, medical coders, accreditation organizations, payers, and health information technology professionals to easily exchange data on the medical services and procedures provided to patients. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes.

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 House Resolution 349, which would support the goals of Overdose Awareness Day by lowering the United States flag to halfstaff on all Federal buildings on August 31st of each year. 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 changes to a draft opioid treatment program bill to 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 Submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) outlining suggested improvements to the proposed Physician Payment Schedule for calendar year (CY) 2022. Among other recommendations, ASAM urged that CMS work with Congress to avoid a 2.5% cut in reimbursements for addiction medicine (ADM), finalize coding and payment rules for take-home naloxone nasal spray, and extend audio-only flexibility for opioid treatment programs (OTPs) to furnish therapy and counseling payments for substance use disorder (SUD). Advocated for the inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 nomination of Dr. Rahul Gupta to lead the Office of National Drug Control Policy (ONDCP), a critical position for coordinating the nations drug policy and response to the nations drug addiction and overdose crisis. Supported the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 2069/H.R. 4323). This legislation would allow for every state and territory the ability to join the Certified Community Behavioral Health Clinic (CCBHC) demonstration and would authorize investments in the model for current and prospective CCBHCs. 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). Advocated for H.R. 2786/ S. 1314, the Tobacco Tax Equity Act of 2021, which would increase the federal excise tax on cigarettes and set federal tax rates for other tobacco products at an equivalent level. Supported the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee Advocated for passage of the Advancing FASD Research, Services, and Prevention Act (S.2238 and H.R.4151), known as the FASD Respect Act. The legislation would in part reauthorize and strengthen existing federal FASD programs at NIAAA, CDC, and HRSA, and for the first time calls for long-neglected, meaningful support for individuals and families living with FASD. 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. Supported the National Committee on Vital and Health Statistics (NCVHS) efforts to enhance the exchange of clinical and administrative data through their recommendations to the Secretary but highlighted the important role of the Current Procedural Terminology (CPT) code set as serving the needs of a data-driven health system by allowing physicians, patients, researchers, medical groups, allied health care professionals, health systems, hospitals, medical coders, accreditation organizations, payers, and health information technology professionals to easily exchange data on the medical services and procedures provided to patients. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes.

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 House Resolution 349, which would support the goals of Overdose Awareness Day by lowering the United States flag to halfstaff on all Federal buildings on August 31st of each year. 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 changes to a draft opioid treatment program bill to 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 Submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) outlining suggested improvements to the proposed Physician Payment Schedule for calendar year (CY) 2022. Among other recommendations, ASAM urged that CMS work with Congress to avoid a 2.5% cut in reimbursements for addiction medicine (ADM), finalize coding and payment rules for take-home naloxone nasal spray, and extend audio-only flexibility for opioid treatment programs (OTPs) to furnish therapy and counseling payments for substance use disorder (SUD). Advocated for the inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 nomination of Dr. Rahul Gupta to lead the Office of National Drug Control Policy (ONDCP), a critical position for coordinating the nations drug policy and response to the nations drug addiction and overdose crisis. Supported the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 2069/H.R. 4323). This legislation would allow for every state and territory the ability to join the Certified Community Behavioral Health Clinic (CCBHC) demonstration and would authorize investments in the model for current and prospective CCBHCs. 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). Advocated for H.R. 2786/ S. 1314, the Tobacco Tax Equity Act of 2021, which would increase the federal excise tax on cigarettes and set federal tax rates for other tobacco products at an equivalent level. Supported the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee Advocated for passage of the Advancing FASD Research, Services, and Prevention Act (S.2238 and H.R.4151), known as the FASD Respect Act. The legislation would in part reauthorize and strengthen existing federal FASD programs at NIAAA, CDC, and HRSA, and for the first time calls for long-neglected, meaningful support for individuals and families living with FASD. 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. Supported the National Committee on Vital and Health Statistics (NCVHS) efforts to enhance the exchange of clinical and administrative data through their recommendations to the Secretary but highlighted the important role of the Current Procedural Terminology (CPT) code set as serving the needs of a data-driven health system by allowing physicians, patients, researchers, medical groups, allied health care professionals, health systems, hospitals, medical coders, accreditation organizations, payers, and health information technology professionals to easily exchange data on the medical services and procedures provided to patients. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes.

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 House Resolution 349, which would support the goals of Overdose Awareness Day by lowering the United States flag to halfstaff on all Federal buildings on August 31st of each year. 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 changes to a draft opioid treatment program bill to 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 Submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) outlining suggested improvements to the proposed Physician Payment Schedule for calendar year (CY) 2022. Among other recommendations, ASAM urged that CMS work with Congress to avoid a 2.5% cut in reimbursements for addiction medicine (ADM), finalize coding and payment rules for take-home naloxone nasal spray, and extend audio-only flexibility for opioid treatment programs (OTPs) to furnish therapy and counseling payments for substance use disorder (SUD). Advocated for the inclusion of enhanced mental health and substance use disorder (SUD) parity enforcement within the Senates version of the budget reconciliation proposal. These enhanced enforcement measures would authorize the Department of Labor to assess civil monetary penalties against insurers that violate the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported $195 million over five years to the Employee Benefits Security Administration for enforcement. 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 nomination of Dr. Rahul Gupta to lead the Office of National Drug Control Policy (ONDCP), a critical position for coordinating the nations drug policy and response to the nations drug addiction and overdose crisis. Supported the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 2069/H.R. 4323). This legislation would allow for every state and territory the ability to join the Certified Community Behavioral Health Clinic (CCBHC) demonstration and would authorize investments in the model for current and prospective CCBHCs. 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). Advocated for H.R. 2786/ S. 1314, the Tobacco Tax Equity Act of 2021, which would increase the federal excise tax on cigarettes and set federal tax rates for other tobacco products at an equivalent level. Supported the tobacco tax provisions included in the portion of the Build Back Better Act that was approved by the Ways and Means Committee Advocated for passage of the Advancing FASD Research, Services, and Prevention Act (S.2238 and H.R.4151), known as the FASD Respect Act. The legislation would in part reauthorize and strengthen existing federal FASD programs at NIAAA, CDC, and HRSA, and for the first time calls for long-neglected, meaningful support for individuals and families living with FASD. 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. Supported the National Committee on Vital and Health Statistics (NCVHS) efforts to enhance the exchange of clinical and administrative data through their recommendations to the Secretary but highlighted the important role of the Current Procedural Terminology (CPT) code set as serving the needs of a data-driven health system by allowing physicians, patients, researchers, medical groups, allied health care professionals, health systems, hospitals, medical coders, accreditation organizations, payers, and health information technology professionals to easily exchange data on the medical services and procedures provided to patients. Supported draft legislation that would amend the Controlled Substances Act to increase the number of days before which certain controlled substances for maintenance or detoxification treatment must be administered, and for other purposes.

Preserve Medicaid and Affordable Care Act Medicaid expansion. Preserve Medicaid funding and Medicaid disproportionate share hospital payments. Support easing the Medicaid IMD exclusion including support for the Increasing Behavioral Health Treatment Act (H.R. 2611). Support easing the Medicaid inmate exclusion, including support for the Humane Correctional Health Care Act (S. 1821/H.R. 3514).

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE