WASHINGTON, D.C. – U.S. Senators Shelley Moore Capito (R-W.Va.) and Joe Manchin (D-W.Va.), along with U.S. Representatives David McKinley (R-W.Va.-1), Alex Mooney (R-W.Va.-2), and Carol Miller (R-W.Va.-3) yesterday sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma calling for immediate action to address a decision by CMS that could negatively affect access to treatment for opioid addiction. This action comes as West Virginia continues to battle both the COVID-19 public health emergency and the ongoing opioid epidemic.
The issue arises from CMS’ interpretation of a provision within the SUPPORT for Patients and Communities Act, bipartisan legislation to address the nation’s opioid crisis that was signed into law in 2018. The provision, Section 1006(b), seeks to ensure Medicaid beneficiaries have access to all forms of Medication-Assisted Therapy (MAT) used to treat opioid dependence. However, CMS has informed states, including West Virginia, that implementation of the provision will change the way they are able to finance the purchase of these medications, resulting in much higher costs for the state’s Medicaid program and potentially tragic drug therapy interruptions and discontinuations.
In their letter, the delegation urged HHS and CMS to act quickly and decisively to avoid the grim clinical implications of CMS’ statutory interpretation. In addition, the members of the delegation continue to work with their Congressional colleagues on possible legislative remedies.
“The SUPPORT Act was intended to facilitate resolution of the opioid use epidemic. We must ensure no actions are taken that would unnecessarily impede movement towards that goal, especially now as we face both this and the COVID-19 pandemic,” the delegation wrote.
The full letter is available here and below.
Dear Secretary Azar and Administrator Verma:
As the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) continue to respond to theCOVID-19 pandemic, the opioid epidemic continues to wreak havoc on communities across West Virginia. We write to express concerns over the Administration’s plans to implement the SUPPORT Act Section 1006(b) Medication-Assisted Therapy (MAT) drug coverage mandate as disqualifying MAT drugs from Medicaid rebates starting October 1, 2020.
As you know, the opioid epidemic remains a public health emergency and is worsened by the coronavirus PHE. Access to treatment is as critical as it was when the SUPPORT Act was enacted. As states grapple to accommodate increasing health costs in the face of decreasing revenue, it is essential the Administrative approach its SUPPORT Act implementation in a manner that empowers the states to effectively address the dual public health crises they face.
Section 1006(b) of the SUPPORT Act was intended to address the fact that several states were not covering all forms of MAT with a five-year coverage mandate. The provision sought to ensure Medicaid beneficiaries retained access to office-based MAT and that all states also covered care delivered by opioid treatment programs (OTPs), such as methadone clinics.
The Centers for Medicare & Medicaid Services (CMS) and its Office of General Counsel have conveyed to stakeholders that Sec. 1006(b) requires state Medicaid programs to not only ensure coverage of methadone in OTPs as well as office-based MAT, but that they do so without the financial support ordinarily received from manufacturers in the form of statutory and supplemental Medicaid rebates. We have assured health system leaders in our states that Congress did not intend to simultaneously increase state coverage obligations and reduce Medicaid revenue sources.
We strongly encourage HHS and CMS to act quickly and decisively to utilize the types of flexibilities the Administration has implemented to address the coronavirus PHE to avoid the grim clinical implications of CMS’ statutory interpretation. The SUPPORT Act was intended to facilitate resolution of the opioid use epidemic. We must ensure no actions are taken that would unnecessarily impede movement towards that goal, especially now as we face both this and the COVID-19 pandemic.
Thank you for your prompt consideration of this matter. We look forward to working together on a timely and effective solution.
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